Individual provider Active NPI

Reversa R. Joseph, MD

  • Neurology Physician
  • Columbus, OH
National Provider Identifier
1770726390
Registry record updated Jul 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
35128955 Issued in OH
Practice address
420 N James Rd
Columbus, OH 43219
Phone
(614) 257-5200
NPI assigned
Apr 13, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 35128955 OH Primary

Addresses

Primary practice location

420 N James Rd
Columbus, OH 43219

Mailing address

420 N James Rd
Columbus, OH 43219-1834
Phone (614) 257-5208

Other practice location 1

480 Medical Center Dr
1st Floor
Columbus, OH 43210-1229
Phone (614) 293-4969

Other identifiers 1

IdentifierTypeStateIssuer
0185738MedicaidOH

Other names 1

  • Reversa R. Mills Former name

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
I20161101002616 OH Practitioner - Neurology 8729366364 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Georgetown University School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Evokes LLCGroup PAC ID 4880983832, 19 clinicians

Practice addresses (Care Compare)

2164 Strathshire Hall LN
Powell, OH 43065-8748
Phone 4843518459202

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35128955OHMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Titan Neurophysiology PA Neurology CurrentSince Feb 1, 2021 Accepting new patients
Medsurant, LLC Neurology CurrentSince Sep 1, 2020 Accepting new patients
Evokes, LLC Neurology CurrentSince Aug 6, 2018 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1141 N Loop 1604 E
Ste 105484
San Antonio, TX 78232

Interoperability endpoints

  • Direct secure messaging: rjoseph285634@direct.uchealth.com

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": "1239580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532649600000",
    "number": "1770726390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 N JAMES RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432191834",
            "telephone_number": "614-257-5208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 N JAMES RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "43219",
            "telephone_number": "614-257-5200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "480 Medical Center Dr",
            "address_2": "1st Floor",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432101229",
            "country_code": "US",
            "telephone_number": "614-293-4969",
            "fax_number": "614-293-6111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOSEPH",
        "first_name": "REVERSA",
        "middle_name": "R.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-13",
        "last_updated": "2018-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "OH",
            "license": "35128955",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0185738",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REVERSA",
            "last_name": "MILLS",
            "middle_name": "R.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.