Paul W Kolodzik, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

35052684 Issued in OH

Practice address

550 Mirabeau St
Greenfield, OH 45123-1617

Phone

(937) 981-2216

Fax

(937) 981-9238

NPI assigned

Jun 7, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 12

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• North Dayton Addiction & Recovery, LLC

  • Clinic/Center
  • Vandalia, OH
  • NPI 1649794884
  NPD Authorized official
• East Indiana Recovery, LLC

  • Addiction Medicine (Family Medicine) Physician
  • Richmond, IN
  • NPI 1013418599
  NPD Authorized official
• Highland Hospitalist Services Medical Group

  • Internal Medicine Physician
  • Hillsboro, OH
  • NPI 1184666497
  NPD (past) Authorized official
• Hospital Services Medical Group of Clark County Inc

  • Internal Medicine Physician
  • Springfield, OH
  • NPI 1588659841
  NPD (past) Authorized official
• Hospitalist Services Medical Group of Anderson Township, Inc.

  • Hospitalist Physician
  • Cincinnati, OH
  • NPI 1023000536
  NPD (past) Authorized official
• Hospitalist Services Medical Group of Hamilton, Inc.

  • Internal Medicine Physician
  • Hamilton, OH
  • NPI 1730174087
  NPD (past) Authorized official
• Hospitalist Services Medical Group of Springfield, Inc.

  • Internal Medicine Physician
  • Urbana, OH
  • NPI 1124014261
  NPD (past) Authorized official
• JTDM Family Practice LLC

  • Family Medicine Physician
  • St Marys, OH
  • NPI 1184652539
  NPD (past)
• Madison Emergency Physicians Inc

  • Emergency Medicine Physician
  • London, OH
  • NPI 1720089766
  NPD (past)
• Marysville Emergency Physicians Inc.

  • Emergency Medicine Physician
  • Marysville, OH
  • NPI 1649271594
  NPD (past)
• Qualified Emergency Specialists Inc

  • Emergency Medicine Physician
  • Cincinnati, OH
  • NPI 1700872728
  NPD (past)
• Spfld Urb Emergency Physicians Inc

  • Emergency Medicine Physician
  • Urbana, OH
  • NPI 1407858871
  NPD (past)

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585526400000",
    "number": "1760422869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4750 HEMPSTEAD STATION DR",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454295164",
            "telephone_number": "800-875-0136",
            "fax_number": "937-619-4231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 MIRABEAU ST",
            "city": "GREENFIELD",
            "state": "OH",
            "postal_code": "451231617",
            "telephone_number": "937-981-2216",
            "fax_number": "937-981-9238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLODZIK",
        "first_name": "PAUL",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2020-03-30",
        "certification_date": "2020-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35052684",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0608006",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000537070",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "P00206144",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201007380",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00111883",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "000000329196",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS FOR UVMC",
            "identifier": "000000315973",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000000316737",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS/MARYSVILLE",
            "identifier": "000000351194",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000531260",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00441746",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE FOR UVMC",
            "identifier": "P00307842",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Debra Kennedy
• Julia Rebecca Kent
• Debra Kinnison
• Scott Kinnison
• Karl Knutsson
• Brandon Kysor
• Jordan Langley
• Paula Kim Lawless
• Amy Lynn Leeth, COTA/L
• Courtney Lemons

• Emergency Medicine Physician in Greenfield, OH
• Providers in Greenfield, OH by specialty
• Emergency Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2020; 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.