NPIMap

Organization Active NPI

Grant/Riverside Medical Care Foundation

  • Durable Medical Equipment & Medical Supplies
  • Canal Winchester, OH
National Provider Identifier
1881706091
Registry record updated Jul 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
GRANT/RIVERSIDE MEDICAL CARE FOUNDATION
Practice address
11925 Lithopolis Rd NW
Tricounty Family Medicine
Canal Winchester, OH 43110-9585
Phone
(614) 837-6363
Fax
(614) 837-0425
NPI assigned
Sep 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2008

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

Authorized official

Name
Tracy Hedges
Title
Credentialing Specialist
Phone
(614) 544-6356

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

11925 Lithopolis Rd NW
Tricounty Family Medicine
Canal Winchester, OH 43110-9585

Mailing address

5350 Frantz Rd
Dublin, OH 43016-4259

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidOH

Other names 1

  • TriCounty Family Medicine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Columbus General Intern8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216771200000",
    "number": "1881706091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5350 FRANTZ RD",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430164259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11925 LITHOPOLIS RD NW",
            "address_2": "TRICOUNTY FAMILY MEDICINE",
            "city": "CANAL WINCHESTER",
            "state": "OH",
            "postal_code": "431109585",
            "telephone_number": "614-837-6363",
            "fax_number": "614-837-0425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANT/RIVERSIDE MEDICAL CARE FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-01",
        "last_updated": "2008-07-23",
        "status": "A",
        "authorized_official_last_name": "HEDGES",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "614-544-6356"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TriCounty Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Canal Winchester, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2008; 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.