Organization Active NPI

Marion Independent Physicians Association, LLC

  • Family Medicine Physician
  • Marion, OH
National Provider Identifier
1710925045
Registry record updated Jun 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MARION INDEPENDENT PHYSICIANS ASSOCIATION, LLC
Practice address
30D Executive Drive
Marion, OH 43302-6310
Phone
(740) 387-7793
Fax
(740) 387-7795
NPI assigned
Jun 2, 2006
Last updated
Jun 28, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
MARION INDEPENDENT PHYSICIANS ASSOCIATION, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 28, 2021

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

Authorized official

Name
Srinivas Ravi
Title
MD
Phone
(740) 387-7793

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X
Anesthesiology Physician 207L00000X
Family Medicine Physician 207Q00000X Primary
Internal Medicine Physician 207R00000X
Cardiovascular Disease Physician 207RC0000X
Hematology & Oncology Physician 207RH0003X
Orthopaedic Surgery Physician 207X00000X
Neurology Physician 2084N0400X
Psychiatry Physician 2084P0800X
Surgery Physician 208600000X
Urology Physician 208800000X
Podiatrist 213E00000X
Physical Therapist 225100000X
Physician Assistant 363A00000X
Nurse Practitioner 363L00000X

Addresses

Primary practice location

30D Executive Drive
Marion, OH 43302-6310

Mailing address

P.O. Box 887
Marion, OH 43301-0887
Phone (740) 223-3496

Other identifiers 14

IdentifierTypeStateIssuer
2104136MedicaidOH
2105279MedicaidOH
2105331MedicaidOH
2105359MedicaidOH
2105242MedicaidOH
2104127MedicaidOH
2105251MedicaidOH
2105386MedicaidOH
2105475MedicaidOH
2105519MedicaidOH
2105288MedicaidOH
2105224MedicaidOH
2105322MedicaidOH
2105411MedicaidOH

National Provider Directory

National Provider Directory
Part of
Marion Independent PH

Locations

1021 Harding Memorial Pkwy
Marion, OH 43302
Phone (740) 387-4037

1065 Delaware Ave
Ste 159
Marion, OH 43302
Phone (614) 382-1270

1069 Delaware Ave
Ste 103
Marion, OH 43302
Phone (614) 382-5541

1069 Delaware Ave
Ste 205
Marion, OH 43302
Phone (740) 223-3496

1167 Independence Ave
Ste 100
Marion, OH 43302
Phone (740) 378-7200

125 Executive Dr
Marion, OH 43302
Phone (740) 401-0880

125 Executive Dr
Ste 202
Marion, OH 43302

125 Executive Dr
Ste 207
Marion, OH 43302
Phone (740) 223-8056

300 Executive Dr
Marion, OH 43302
Phone (740) 387-7793

Practitioners & affiliated clinicians

Practitioners 20

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 20

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624838400000",
    "number": "1710925045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 887",
            "city": "MARION",
            "state": "OH",
            "postal_code": "433010887",
            "telephone_number": "740-223-3496",
            "fax_number": "740-383-6463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30D EXECUTIVE DRIVE",
            "city": "MARION",
            "state": "OH",
            "postal_code": "433026310",
            "telephone_number": "740-387-7793",
            "fax_number": "740-387-7795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARION INDEPENDENT PHYSICIANS ASSOCIATION, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MARION INDEPENDENT PHYSICIANS ASSOCIATION, LLC",
        "enumeration_date": "2006-06-02",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-28",
        "status": "A",
        "authorized_official_last_name": "RAVI",
        "authorized_official_first_name": "SRINIVAS",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "740-387-7793"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2104136",
            "state": "OH"
        },
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            "code": "05",
            "desc": "MEDICAID",
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            "identifier": "2105279",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2105331",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2105359",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2105242",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2104127",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2105251",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2105386",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2105475",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2105519",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2105288",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2105224",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2105322",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2105411",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2021; 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.