Individual provider Active NPI

Monique Charmion Ganucheau, ANP-BC

  • Adult Health Nurse Practitioner
  • Columbus, OH
National Provider Identifier
1881921674
Registry record updated Apr 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
COA11137NP Issued in OH
Practice address
800 McConnell Rd
Columbus, OH 43214-3463
Phone
(614) 566-5377
Fax
(614) 533-6200
NPI assigned
Nov 16, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN340379COA1 OH
Adult Health Nurse Practitioner 363LA2200X COA11137NP OH Primary

Addresses

Primary practice location

800 McConnell Rd
Columbus, OH 43214-3463

Mailing address

5350 Frantz Rd
Dublin, OH 43016-4259

Other identifiers 1

IdentifierTypeStateIssuer
3039027MedicaidOH

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091204000010 OH Practitioner - Nurse Practitioner 4981743952 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mount Carmel Health SystemGroup PAC ID 6709793367, 84 clinicians

Practice addresses (Care Compare)

477 Cooper Rd
Suite 300
Westerville, OH 43081-8057
Phone (614) 898-8808

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN340379COA1OHMDRegistered Nurse
COA11137NPOHMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ohiohealth Corporation CurrentSince Nov 14, 2011 Accepting new patients
Mount Carmel Health System CurrentSince Oct 1, 2018 Accepting new patients
Ohiohealth Corporation CurrentSince Nov 14, 2011 Accepting new patients
Mount Carmel Health System CurrentSince Oct 1, 2018 Accepting new patients
Osu Internal Medicine, LLC Past Accepting new patients

Locations

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

Dept L3652
Columbus, OH 43260

800 McConnell Dr
Columbus, OH 43214
Phone (614) 533-6297

5350 Frantz Rd
Dublin, OH 43016

1130 Independence Ave
Marion, OH 43302
Phone (740) 383-8591

477 Cooper Rd
Ste 300
Westerville, OH 43081
Phone (614) 898-8808

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1258329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398384000000",
    "number": "1881921674",
    "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": "800 MCCONNELL RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432143463",
            "telephone_number": "614-566-5377",
            "fax_number": "614-533-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANUCHEAU",
        "first_name": "MONIQUE",
        "middle_name": "CHARMION",
        "name_prefix": "Ms.",
        "credential": "ANP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-16",
        "last_updated": "2014-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN340379COA1",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "COA11137NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3039027",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.