Northridge Family Practice LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

35042158B Issued in OH

Legal business name

NORTHRIDGE FAMILY PRACTICE LLC

Practice address

610 Northridge Rd
Circleville, OH 43113

Phone

(740) 474-3159

Fax

(740) 474-2110

NPI assigned

Nov 10, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Deborah Lea Lewis

Title

Office Manager

Phone

(740) 474-3159

Specialties & licenses 4

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576022400000",
    "number": "1669453189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 NORTHRIDGE RD",
            "address_2": "PO BOX 578",
            "city": "CIRCLEVILLE",
            "state": "OH",
            "postal_code": "43113",
            "telephone_number": "740-474-3159",
            "fax_number": "740-474-2110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 NORTHRIDGE RD",
            "city": "CIRCLEVILLE",
            "state": "OH",
            "postal_code": "43113",
            "telephone_number": "740-474-3159",
            "fax_number": "740-474-2110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHRIDGE FAMILY PRACTICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-10",
        "last_updated": "2019-12-11",
        "certification_date": "2019-12-11",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "LEA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "740-474-3159",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35042158B",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35053974M",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "350463858",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35071002J",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2211430",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily Kathleen Nixon, LPN
• Noble Mental Health LLC
• Gail Annette Noble
• Brianna Laura Nolte
• Northland Hearing Center, Inc.
• Amy Jeanne Nungester, LICDC, LPC
• Karen Nungester
• Trent Nungester, PRS
• Julia Nutter, MOT, OTR/L
• Kelly Kay Nutter, RBT

• Family Medicine Physician in Circleville, OH
• Providers in Circleville, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.