NPIMap

Individual provider Active NPI

Amanda R Fant, MD

  • Internal Medicine Physician
  • Columbus, OH
National Provider Identifier
1780940858
Registry record updated Mar 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35130599 Issued in OH
Practice address
4895 Olentangy River Rd Ste 250
Columbus, OH 43214-1184
Phone
(614) 267-8371
Fax
(614) 262-0005
NPI assigned
Apr 3, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 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 35130599 OH Primary

Addresses

Primary practice location

4895 Olentangy River Rd Ste 250
Columbus, OH 43214-1184

Mailing address

4895 Olentangy River Rd. Ste 250
Columbus, OH 43214-1184
Phone (614) 267-8371

Other identifiers 1

IdentifierTypeStateIssuer
0214594MedicaidOH

Other names 1

  • Amanda K Royse Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170913000545 OH Practitioner - Internal Medicine 9537307723 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Ohio State University College of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Central Ohio Primary Care Physicians, Inc.Group PAC ID 2769383785, 487 clinicians

Practice addresses (Care Compare)

4895 Olentangy River Rd
Suite 100
Columbus, OH 43214-1184
Phone (614) 457-7732

Hospital & facility affiliations

  • Riverside Methodist Hospital Hospital, Columbus, OH, CCN 360006
  • Dublin Methodist Hospital Hospital, Dublin, OH, CCN 360348
  • Ohio State University State Health System Hospital, Columbus, OH, CCN 360085
  • Grant Medical Center Hospital, Columbus, OH, CCN 360017
  • James Cancer Hospital & Solove Research Institute Hospital, Columbus, OH, CCN 360242

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35130599OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Ohio Primary Care Physicians Inc Current Accepting new patients

Locations

655 Africa Rd
Westerville, OH 43082

Interoperability endpoints

  • Direct secure messaging: afant18963@copcp.medicity.net

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1333411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522368000000",
    "number": "1780940858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4895 OLENTANGY RIVER RD. STE 250",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432141184",
            "telephone_number": "614-267-8371",
            "fax_number": "614-262-0005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4895 OLENTANGY RIVER RD STE 250",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432141184",
            "telephone_number": "614-267-8371",
            "fax_number": "614-262-0005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANT",
        "first_name": "AMANDA",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-03",
        "last_updated": "2018-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35130599",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0214594",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "ROYSE",
            "middle_name": "K",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.