Individual provider Active NPI

Christopher Todd Marazon, D.O.

  • Family Medicine Physician
  • Gallipolis, OH
National Provider Identifier
1700803699
Registry record updated Oct 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34.008258 Issued in OH
Practice address
1051 4TH Ave
Gallipolis, OH 45631-1562
Phone
(740) 446-5244
Fax
(740) 446-6300
NPI assigned
Jul 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 34.008258 OH Primary
General Practice Physician 208D00000X 34.008258 OH

Addresses

Primary practice location

1051 4TH Ave
Gallipolis, OH 45631-1562

Mailing address

90 Jackson Pike
Gallipolis, OH 45631-1560
Phone (740) 446-5244

Other identifiers 4

IdentifierTypeStateIssuer
3810020351MedicaidWV
000000492056OtherOHOH MEDICAID UNISON
310917085293OtherOHOH MEDICAID CARESOURCE
2932876MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address christopher.marazon.1@17389.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090302000187 OH Practitioner - Family PracticePractitioner - Emergency Medicine 6204992100 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Ohio University, College of Osteopathic Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Holzer Clinic LLCGroup PAC ID 5890606008, 266 clinicians

Practice addresses (Care Compare)

1051 4TH Ave
Gallipolis, OH 45631-1612
Phone (740) 446-5244

Hospital & facility affiliations

  • Pleasant Valley Home Health Home health agency, Gallipolis, OH, CCN 368353
  • Holzer Home Care Home health agency, Gallipolis, OH, CCN 367117
  • Holzer Medical Center Hospice Hospice, Gallipolis, OH, CCN 361580
  • Holzer Medical Center Hospital, Gallipolis, OH, CCN 360054
  • Holzer Medical Center Jackson Hospital, Jackson, OH, CCN 361320
  • Holzer Senior Care Center Nursing home, Bidwell, OH, CCN 365998

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue155
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
34.008258OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Holzer Clinic, LLC CurrentSince Jul 23, 2012 Accepting new patients
I Path LLC Current Accepting new patients
Holzer Senior Care Center Past Accepting new patients

Locations

936 State Route 160
Gallipolis, OH 45631
Phone (740) 446-4600

100 Jackson Pike
Gallipolis, OH 45631
Phone (740) 446-5050

90 Jackson Pike
Gallipolis, OH 45631
Phone (740) 446-5131

500 Burlington Rd
Jackson, OH 45640
Phone (740) 288-4625

Interoperability endpoints

  • Direct secure messaging: christopher.marazon.1@17389.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1700803699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 JACKSON PIKE",
            "city": "GALLIPOLIS",
            "state": "OH",
            "postal_code": "456311560",
            "telephone_number": "740-446-5244",
            "fax_number": "740-446-6300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 4TH AVE",
            "city": "GALLIPOLIS",
            "state": "OH",
            "postal_code": "456311562",
            "telephone_number": "740-446-5244",
            "fax_number": "740-446-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARAZON",
        "first_name": "CHRISTOPHER",
        "middle_name": "TODD",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-16",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34.008258",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "OH",
            "license": "34.008258",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810020351",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OH MEDICAID UNISON",
            "identifier": "000000492056",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OH MEDICAID CARESOURCE",
            "identifier": "310917085293",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2932876",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "christopher.marazon.1@17389.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "1051 4th Ave",
            "city": "Gallipolis",
            "state": "OH",
            "country_code": "US",
            "postal_code": "456311562",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gallipolis, OH

Sources for this page

Verify at the official NPI Registry.