NPIMap

Organization Active NPI

Damascus Family Medicine, Inc.

  • Family Medicine Physician
  • Marysville, OH
National Provider Identifier
1679522015
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35-06-5804 Issued in OH
Legal business name
DAMASCUS FAMILY MEDICINE, INC.
Practice address
388 Damascus Rd
Suite a
Marysville, OH 43040-8507
Phone
(937) 578-4040
Fax
(937) 587-2602
NPI assigned
May 10, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Delia J. Herzog, M.D.NPI 1285684282
Title
President
Phone
(937) 578-4040

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 35-06-5804 OH Primary

Addresses

Primary practice location

388 Damascus Rd
Suite a
Marysville, OH 43040-8507

Mailing address

200 Bradenton Ave
Dublin, OH 43017-7515
Phone (614) 793-1980

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D2174352Memorial Damascus Family Medicine388 Damascus Rd, Marysville, OH 43040Provider-performed microscopyOct 29, 2027

National Provider Directory

National Provider Directory

Locations

200 Bradenton Ave
Dublin, OH 43017
Phone (614) 793-1080

Practitioners & affiliated clinicians

Practitioners 4

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": "1147219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1679522015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 BRADENTON AVE",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430177515",
            "telephone_number": "614-793-1980",
            "fax_number": "614-793-1985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "388 DAMASCUS RD",
            "address_2": "SUITE A",
            "city": "MARYSVILLE",
            "state": "OH",
            "postal_code": "430408507",
            "telephone_number": "937-578-4040",
            "fax_number": "937-587-2602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAMASCUS FAMILY MEDICINE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HERZOG",
        "authorized_official_first_name": "DELIA",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "937-578-4040",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35-06-5804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marysville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.