Physician's Practice Organization

Primary specialty

SpecialistTaxonomy code 174400000X

License

01037446 Issued in IN

Legal business name

PHYSICIAN'S PRACTICE ORGANIZATION

Doing business as

Columbus Gynecology and Adult Medicine

Practice address

2326 18TH St
Suite 210
Columbus, IN 47201-5359

Phone

(812) 372-8426

Fax

(812) 372-8301

NPI assigned

Jan 18, 2007

Last updated

Dec 17, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Mike Robertson

Title

Practice Manager

Phone

(812) 372-8426

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Columbus Gynecology and Adult Medicine Doing business as

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197849600000",
    "number": "1790837789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2326 18TH ST",
            "address_2": "SUITE 210",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472015359",
            "telephone_number": "812-372-8426",
            "fax_number": "812-372-8301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2326 18TH ST",
            "address_2": "SUITE 210",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472015359",
            "telephone_number": "812-372-8426",
            "fax_number": "812-372-8301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIAN'S PRACTICE ORGANIZATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2007-12-17",
        "status": "A",
        "authorized_official_last_name": "ROBERTSON",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "812-372-8426",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IN",
            "license": "01037446",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CF9669",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Columbus Gynecology and Adult Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Specialist in Columbus, IN
• Providers in Columbus, IN by specialty
• Specialist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 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.