NPIMap

Organization Active NPI

Lower Lights Christian Health Center, Inc

Doing business as Union Star Health Center

  • Primary Care Clinic/Center
  • Marysville, OH
National Provider Identifier
1699114108
Registry record updated Mar 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
LOWER LIGHTS CHRISTIAN HEALTH CENTER, INC
Doing business as
Union Star Health Center
Practice address
773 S Walnut St
Marysville, OH 43040-1643
Phone
(614) 274-1455
Fax
(614) 274-1433
NPI assigned
Jun 18, 2013
Last updated
Mar 11, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2022

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

Authorized official

Name
Clifford Osborne
Title
Credentialing Specialist
Phone
(614) 274-1544

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

773 S Walnut St
Marysville, OH 43040-1643

Mailing address

1160 W Broad St
Columbus, OH 43222-1317
Phone (614) 274-1455

Other identifiers 1

IdentifierTypeStateIssuer
0455637MedicaidOH

Other names 1

  • Union Star Health Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140702000762 OH Part B Supplier - Clinic/Group Practice 5193794188 Receives reassigned benefits from 83 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Newark, OH; Westerville, OH; Marysville, OH; Columbus, OH

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 76

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.

View all 76

NPI Registry JSON

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

{
    "created_epoch": "1371513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646956800000",
    "number": "1699114108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1160 W BROAD ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432221317",
            "telephone_number": "614-274-1455",
            "fax_number": "614-274-1433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "773 S WALNUT ST",
            "city": "MARYSVILLE",
            "state": "OH",
            "postal_code": "430401643",
            "telephone_number": "614-274-1455",
            "fax_number": "614-274-1433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOWER LIGHTS CHRISTIAN HEALTH CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-18",
        "last_updated": "2022-03-11",
        "certification_date": "2022-03-11",
        "status": "A",
        "authorized_official_last_name": "OSBORNE",
        "authorized_official_first_name": "CLIFFORD",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "614-274-1544"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0455637",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Union Star Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Union Star Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Mar 11, 2022; 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.