Organization Active NPI

Nerves, LLC

  • Specialist
  • Westerville, OH
National Provider Identifier
1649486879
Registry record updated Mar 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
35070094 Issued in OH
Legal business name
NERVES, LLC
Practice address
450 Alkyre Run
Suite 300
Westerville, OH 43082-6909
Phone
(614) 942-0132
Fax
(614) 942-0139
NPI assigned
May 15, 2007
Last updated
Mar 26, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Gunwant S Mallik, MDNPI 1376527663
Title
Owner Physician
Phone
(614) 942-0132

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 35070094 OH Primary

Addresses

Primary practice location

450 Alkyre Run
Suite 300
Westerville, OH 43082-6909

Mailing address

PO Box 712844
Cincinnati, OH 45271-2844
Phone (614) 942-0132

Other identifiers 1

IdentifierTypeStateIssuer
2756218MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070607000278 OH Part B Supplier - Clinic/Group Practice 4587762018 Receives reassigned benefits from 1 practitioner
Practice locations: Powell, OH

National Provider Directory

National Provider Directory

Locations

450 Alkyre Run
Ste 300
Westerville, OH 43082
Phone (614) 396-8286

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206489600000",
    "number": "1649486879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 712844",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452712844",
            "telephone_number": "614-942-0132",
            "fax_number": "614-942-0139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 ALKYRE RUN",
            "address_2": "SUITE 300",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430826909",
            "telephone_number": "614-942-0132",
            "fax_number": "614-942-0139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NERVES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-15",
        "last_updated": "2008-03-26",
        "status": "A",
        "authorized_official_last_name": "MALLIK",
        "authorized_official_first_name": "GUNWANT",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER PHYSICIAN",
        "authorized_official_telephone_number": "614-942-0132",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OH",
            "license": "35070094",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2756218",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westerville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.