NPIMap

Organization Active NPI

Diamonds in Rough Mentoring Program

  • Peer Specialist
  • Columbus, OH
National Provider Identifier
1821796087
Registry record updated Feb 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
Legal business name
DIAMONDS IN ROUGH MENTORING PROGRAM
Practice address
3787 Pendent LN
Columbus, OH 43207-3479
Phone
(614) 966-2271
NPI assigned
Feb 17, 2023
Last updated
Feb 17, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2023

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

Authorized official

Name
Amanda JacksonNPI 1649941576
Title
Ceo/Founder
Phone
(614) 966-2271

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 175T00000X Primary

Addresses

Primary practice location

3787 Pendent LN
Columbus, OH 43207-3479

Mailing address

3787 Pendent LN
Columbus, OH 43207-3479
Phone (614) 966-2271

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1676592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676592000000",
    "number": "1821796087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3787 PENDENT LN",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432073479",
            "telephone_number": "614-966-2271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3787 PENDENT LN",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432073479",
            "telephone_number": "614-966-2271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIAMONDS IN ROUGH MENTORING PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-17",
        "last_updated": "2023-02-17",
        "certification_date": "2023-02-17",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "CEO/FOUNDER",
        "authorized_official_telephone_number": "614-966-2271"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2023; 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.