Integrated Medicine of Ohio LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

INTEGRATED MEDICINE OF OHIO LLC

Practice address

6200 Rockside Woods Blvd N Ste 100
Independence, OH 44131-2392

Phone

(216) 236-0060

Fax

(216) 236-0067

NPI assigned

Feb 3, 2020

Organization subpart

Yes

Parent organization

INTEGRATED MEDICINE OF OHIO LLCAs reported in NPPES

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

Authorized official

Name

Caroline Boardman

Title

Partner/Owner

Phone

(216) 236-0060

Specialties & licenses 1

Addresses

Part of

Integrated Medicine of Ohio

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Integrated Medicine of Ohio LLC

  • General Practice Physician
  • Coventry Township, OH
  • NPI 1437796042
  NPPES parent name

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

{
    "created_epoch": "1580688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580688000000",
    "number": "1699306126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6200 ROCKSIDE WOODS BLVD N STE 100",
            "city": "INDEPENDENCE",
            "state": "OH",
            "postal_code": "441312392",
            "telephone_number": "216-236-0060",
            "fax_number": "216-236-0067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 ROCKSIDE WOODS BLVD N STE 100",
            "city": "INDEPENDENCE",
            "state": "OH",
            "postal_code": "441312392",
            "telephone_number": "216-236-0060",
            "fax_number": "216-236-0067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED MEDICINE OF OHIO LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INTEGRATED MEDICINE OF OHIO LLC",
        "enumeration_date": "2020-02-03",
        "last_updated": "2020-02-03",
        "certification_date": "2020-02-03",
        "status": "A",
        "authorized_official_last_name": "BOARDMAN",
        "authorized_official_first_name": "CAROLINE",
        "authorized_official_title_or_position": "PARTNER/OWNER",
        "authorized_official_telephone_number": "216-236-0060"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Independence, OH
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• General Practice Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.