Individual provider Active NPI

Derrick Justin Nitsche, M.D.

  • Emergency Medicine Physician
  • Washington Court House, OH
National Provider Identifier
1801139209
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
35128596 Issued in OH
Practice address
1430 Columbus Ave
Washington Court House, OH 43160-1703
Phone
(740) 335-1210
NPI assigned
Apr 3, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 35128596 OH Primary

Addresses

Primary practice location

1430 Columbus Ave
Washington Court House, OH 43160-1703

Mailing address

700 Ackerman Rd Ste 2120
Columbus, OH 43202-1559
Phone (740) 335-1210

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
I20160628001328 OH Practitioner - Emergency Medicine 4183915861 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Texas Medical School at San Antonio, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osup Community Outreach LLCGroup PAC ID 5799008082, 147 clinicians

Practice addresses (Care Compare)

1430 Columbus Ave
Washington Court House, OH 43160-1703
Phone (740) 355-1210

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Osup Community Outreach LLC CurrentSince Jul 1, 2022 Accepting new patients
Highland District Hospital CurrentSince Oct 1, 2020 Accepting new patients
Highland District Hospital CurrentSince Oct 1, 2020 Accepting new patients

Locations

700 Ackerman Rd
Ste 2120
Columbus, OH 43202

1275 N High St
Hillsboro, OH 45133
Phone (937) 393-5503

6100 N Hamilton Rd
Westerville, OH 43081
Phone (614) 814-8100

1430 Columbus Ave
Wshngtn Ct Hs, OH 43160
Phone (740) 333-2705

Interoperability endpoints

  • Direct secure messaging: derrick.nitsche@xdr.hhchealthdirect.org
  • Direct secure messaging: dnitsche1749923@direct.trinity-health.org
  • FHIR API: https://epicscripts.trihealth.com/fhirproxy/api/FHIR/R4/

Organizations & group practices 3

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 2

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": "1364947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1801139209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ACKERMAN RD STE 2120",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021559",
            "telephone_number": "740-335-1210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 COLUMBUS AVE",
            "city": "WASHINGTON COURT HOUSE",
            "state": "OH",
            "postal_code": "431601703",
            "telephone_number": "740-335-1210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NITSCHE",
        "first_name": "DERRICK",
        "middle_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-03",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35128596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington Court House, OH

Sources for this page

Verify at the official NPI Registry.