Dr. Dirk LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

35.052815 Issued in OH

Legal business name

DR. DIRK LLC

Practice address

300 W Spring St Unit 702
Columbus, OH 43215-7651

Phone

(937) 232-8033

Fax

(937) 426-6576

NPI assigned

May 27, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Dirk Norman Juschka, M.D.NPI 1497750137

Title

Ceo

Phone

(937) 402-1000

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dirk N Juschka, MD

  • Family Medicine Physician
  • Westerville, OH
  • NPI 1497750137
  Medicare reassignment Authorized official
• Judith A. Boris, FNP

  • Family Nurse Practitioner
  • Washington Court House, OH
  • NPI 1962453894
  NPD (past)

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

{
    "created_epoch": "1306454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637625600000",
    "number": "1801189592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 609",
            "city": "LUCASVILLE",
            "state": "OH",
            "postal_code": "456480609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W SPRING ST UNIT 702",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432157651",
            "telephone_number": "937-232-8033",
            "fax_number": "937-426-6576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. DIRK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-27",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-23",
        "status": "A",
        "authorized_official_last_name": "JUSCHKA",
        "authorized_official_first_name": "DIRK",
        "authorized_official_middle_name": "NORMAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "937-402-1000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OH",
            "license": "35.052815",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0616033",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Skilled Nursing Facility in Columbus, OH
• Providers in Columbus, OH by specialty
• Skilled Nursing Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.