NPIMap

Organization Active NPI

Ohio State University

Doing business as The Ohio State University College of Optometry

  • Optometrist
  • Columbus, OH
National Provider Identifier
1710900683
Registry record updated Dec 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
OHIO STATE UNIVERSITY
Doing business as
The Ohio State University College of Optometry
Practice address
1664 Neil Ave
Columbus, OH 43201-2333
Phone
(614) 292-2020
Fax
(614) 247-4543
NPI assigned
Jul 25, 2006
Last updated
Dec 10, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2020

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

Authorized official

Name
Dr. Gregory J Nixon, OD, FAAONPI 1972629467
Title
Associate Dean of Clinic Services
Phone
(614) 292-5367

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

1664 Neil Ave
Columbus, OH 43201-2333

Mailing address

1664 Neil Ave
Columbus, OH 43201-2333
Phone (614) 292-2020

Other identifiers 2

IdentifierTypeStateIssuer
6543600MedicaidOH
3810007816MedicaidWV

Other names 1

  • The Ohio State University College of Optometry Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050509000419 OH Part B Supplier - Clinic/Group Practice 6103866207 Receives reassigned benefits from 56 practitioners
1 other NPI on this enrollment
Practice locations: Columbus, OH; Upper Arlington, OH

Other NPIs on the same Medicare enrollment 1

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D2098480Ohio State University College of1664 Neil Ave, 1140 Optometry Clinic, Columbus, OH 43201Certificate of waiverJul 7, 2027

National Provider Directory

National Provider Directory

Locations

1664 Neil Ave
Columbus, OH 43201
Phone (614) 292-2020

338 W 10th Ave
Columbus, OH 43210
Phone (614) 292-2020

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Arthur G James Cancer Hospital and Research InstituteColumbus, OH, CCN 360242 Hospital 5% Or Greater Direct Ownership Interest (100%) Oct 25, 1990
Ohio State University HospitalsColumbus, OH, CCN 360085 Hospital 5% Or Greater Direct Ownership Interest (100%) Dec 30, 2014
Ohio State University Harding HospitalColumbus, OH, CCN 36S085 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 1, 1984
Ohio State University Dodd Rehabilitation HospitalColumbus, OH, CCN 36T085 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 1, 1984

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 66

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 66

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607558400000",
    "number": "1710900683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1664 NEIL AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432012333",
            "telephone_number": "614-292-2020",
            "fax_number": "614-247-4543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1664 NEIL AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432012333",
            "telephone_number": "614-292-2020",
            "fax_number": "614-247-4543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OHIO STATE UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-25",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A",
        "authorized_official_last_name": "NIXON",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "ASSOCIATE DEAN OF CLINIC SERVICES",
        "authorized_official_telephone_number": "614-292-5367",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD, FAAO"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6543600",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810007816",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Ohio State University College of Optometry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.