Organization Active NPI

Ohiohealth Corporation

Doing business as Grant/Riverside Medical Care Foundation, Inc

  • Family Medicine Physician
  • Westerville, OH
National Provider Identifier
1710285812
Registry record updated Mar 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
OHIOHEALTH CORPORATION
Doing business as
Grant/Riverside Medical Care Foundation, Inc
Practice address
300 Polaris Pkwy Ste 2150
Westerville, OH 43082-7808
Phone
(614) 588-0020
Fax
(614) 588-2031
NPI assigned
Mar 14, 2011
Last updated
Mar 14, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2011

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

Authorized official

Name
Mark Wuestewald
Title
Director of Revenue Cycle
Phone
(614) 544-6351

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary
Sports Medicine (Family Medicine) Physician 207QS0010X
Internal Medicine Physician 207R00000X
Sports Medicine (Internal Medicine) Physician 207RS0010X

Addresses

Primary practice location

300 Polaris Pkwy Ste 2150
Westerville, OH 43082-7808

Mailing address

5350 Frantz Rd
Dublin, OH 43016-4259
Phone (614) 544-6356

Other identifiers 1

IdentifierTypeStateIssuer
2083347MedicaidOH

Other names 1

  • Grant/Riverside Medical Care Foundation, Inc Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1300060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300060800000",
    "number": "1710285812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5350 FRANTZ RD",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430164259",
            "telephone_number": "614-544-6356",
            "fax_number": "614-544-6370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 POLARIS PKWY STE 2150",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430827808",
            "telephone_number": "614-588-0020",
            "fax_number": "614-588-2031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OHIOHEALTH CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-14",
        "last_updated": "2011-03-14",
        "status": "A",
        "authorized_official_last_name": "WUESTEWALD",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "DIRECTOR OF REVENUE CYCLE",
        "authorized_official_telephone_number": "614-544-6351"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RS0010X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2083347",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grant/Riverside Medical Care Foundation, Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Westerville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2011; 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.