Individual provider Active NPI

Justin Blake Anderson, MD

  • Family Medicine Physician
  • Columbus, OH
National Provider Identifier
1710553656
Registry record updated Jun 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35.150799 Issued in OH
Practice address
2231 N High St
Columbus, OH 43201-1101
Phone
(614) 293-5123
Fax
(614) 293-4980
NPI assigned
Jun 1, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35.150799 OH Primary

Addresses

Primary practice location

2231 N High St
Columbus, OH 43201-1101

Mailing address

700 Ackerman Rd Ste 2120
Columbus, OH 43202-1559
Phone (614) 293-5123

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
I20240703002111 OH Practitioner - Family Practice 9133663990 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wright State University Boonshoft School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osu General Internal Medicine LLCGroup PAC ID 7517103955, 270 clinicians

Practice addresses (Care Compare)

2050 Kenny Rd
Columbus, OH 43221-3502
Phone (614) 293-8054

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.150799OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Osu General Internal Medicine LLC Family Medicine CurrentSince Jun 1, 2024 Accepting new patients
Osu Family Practice Services Family Medicine Past Accepting new patients
Ohio State University Hospitals Past Accepting new patients

Locations

2050 Kenny Rd
Columbus, OH 43221
Phone (614) 293-8054

700 Ackerman Rd
Ste 2120
Columbus, OH 43202

2231 N High St
Columbus, OH 43201
Phone (614) 293-2700

543 Taylor Ave
Columbus, OH 43203
Phone (614) 685-3333

Interoperability endpoints

  • Direct secure messaging: janderson2006295@direct.trinity-health.org
  • Direct secure messaging: justin.anderson.1@19221.direct.athenahealth.com
  • Direct secure messaging: janderson948840@direct.osumc.edu

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 4

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": "1622505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1710553656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ACKERMAN RD STE 2120",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021559",
            "telephone_number": "614-293-5123",
            "fax_number": "614-293-4980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2231 N HIGH ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432011101",
            "telephone_number": "614-293-5123",
            "fax_number": "614-293-4980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JUSTIN",
        "middle_name": "BLAKE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-01",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35.150799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.