Individual provider Active NPI

Julianne U Moledor, M.D.

  • Family Medicine Physician
  • Columbus, OH
National Provider Identifier
1760466221
Registry record updated Mar 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35-04-6702 Issued in OH
Practice address
1930 Crown Park CT
Columbus, OH 43235-2402
Phone
(614) 457-1793
Fax
(614) 457-0704
NPI assigned
Nov 30, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2011

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 35-04-6702 OH Primary

Addresses

Primary practice location

1930 Crown Park CT
Columbus, OH 43235-2402

Mailing address

1930 Crown Park CT
Columbus, OH 43235-2402
Phone (614) 457-1793

Other identifiers 1

IdentifierTypeStateIssuer
0669334MedicaidOH

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
I20040121000560 OH Practitioner - Family Practice 0446152524 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Central Ohio Primary Care Physicians, Inc. Family Medicine CurrentSince Jul 1, 2000 Accepting new patients
Central Ohio Primary Care Physicians, Inc. CurrentSince Jul 1, 2000 Accepting new patients

Locations

4885 Olentangy River Rd
Columbus, OH 43214
Phone (614) 326-5665

1930 Crown Park Ct
Columbus, OH 43235
Phone (614) 326-0146

3535 Olentangy River Rd
Columbus, OH 43214
Phone (614) 566-1997

291 W Schrock Rd
Ste B
Westerville, OH 43081
Phone (614) 776-5750

570 Polaris Pkwy
Ste 250
Westerville, OH 43082
Phone (614) 459-0216

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300147200000",
    "number": "1760466221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 CROWN PARK CT",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432352402",
            "telephone_number": "614-457-1793",
            "fax_number": "614-457-0704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 CROWN PARK CT",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432352402",
            "telephone_number": "614-457-1793",
            "fax_number": "614-457-0704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLEDOR",
        "first_name": "JULIANNE",
        "middle_name": "U",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-30",
        "last_updated": "2011-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35-04-6702",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0669334",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.