Individual provider Active NPI

Joan E King, D.O.

  • Internal Medicine Physician
  • Columbus, OH
National Provider Identifier
1770567232
Registry record updated Aug 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
34-00-5020 Issued in OH
Practice address
4895 Olentangy River Rd
Suite 200
Columbus, OH 43214
Phone
(614) 326-1502
Fax
(614) 326-3011
NPI assigned
Nov 30, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 34-00-5020 OH Primary

Addresses

Primary practice location

4895 Olentangy River Rd
Suite 200
Columbus, OH 43214

Mailing address

4895 Olentangy River Rd
Suite 200
Columbus, OH 43214-1926
Phone (614) 326-1502

Other identifiers 1

IdentifierTypeStateIssuer
0836457MedicaidOH

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
I20040526001516 OH Practitioner - Internal Medicine 8325029242 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Central Ohio Primary Care Physicians, Inc. Internal Medicine CurrentSince May 1, 2004 Accepting new patients
Central Ohio Primary Care Physicians, Inc. CurrentSince May 1, 2004 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Davidson Road Primary Care, Inc PastSince Dec 16, 2010 Accepting new patients

Locations

4830 Knightsbridge Blvd
Ste A
Columbus, OH 43214
Phone (614) 451-2174

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

4605 Sawmill Rd
Ste 102
Columbus, OH 43220
Phone (614) 326-1502

4895 Olentangy River Rd
Ste 200
Columbus, OH 43214
Phone (614) 326-1502

4605 Sawmill Rd
Upper Arlngtn, OH 43220
Phone (614) 827-1050

655 Africa Rd
Westerville, OH 43082

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

Organizations & group practices 4

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": "1535414400000",
    "number": "1770567232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4895 OLENTANGY RIVER RD",
            "address_2": "SUITE 200",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432141926",
            "telephone_number": "614-326-1502",
            "fax_number": "614-326-3011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4895 OLENTANGY RIVER RD",
            "address_2": "SUITE 200",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "43214",
            "telephone_number": "614-326-1502",
            "fax_number": "614-326-3011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "JOAN",
        "middle_name": "E",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-30",
        "last_updated": "2018-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "34-00-5020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0836457",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.