Organization Active NPI

Family Health Care of Marysville, LLC

  • Family Medicine Physician
  • Marysville, OH
National Provider Identifier
1770539629
Registry record updated Sep 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35-05-5046 Issued in OH
Legal business name
FAMILY HEALTH CARE OF MARYSVILLE, LLC
Practice address
681 London Ave
Marysville, OH 43040-1599
Phone
(937) 642-2862
Fax
(937) 642-9862
NPI assigned
May 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2007

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

Authorized official

Name
Dr. Connie J. Warren, M.D.NPI 1801833504
Title
Owner
Phone
(937) 578-2860

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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 35-05-5046 OH Primary

Addresses

Primary practice location

681 London Ave
Marysville, OH 43040-1599

Mailing address

200 Bradenton Ave
Dublin, OH 43017-7515

Other identifiers 1

IdentifierTypeStateIssuer
2581764MedicaidOH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189036800000",
    "number": "1770539629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 BRADENTON AVE",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430177515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "681 LONDON AVE",
            "city": "MARYSVILLE",
            "state": "OH",
            "postal_code": "430401599",
            "telephone_number": "937-642-2862",
            "fax_number": "937-642-9862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HEALTH CARE OF MARYSVILLE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-25",
        "last_updated": "2007-09-06",
        "status": "A",
        "authorized_official_last_name": "WARREN",
        "authorized_official_first_name": "CONNIE",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "937-578-2860",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35-05-5046",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2581764",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marysville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2007; 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.