NPIMap

Individual provider Active NPI

John A Paulus, PHD

  • Psychologist
  • Columbus, OH
National Provider Identifier
1891753554
Registry record updated Oct 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
4555 Issued in OH
Practice address
1670 Upham Dr
Columbus, OH 43210-1250
Phone
(614) 293-9600
Fax
(614) 293-9467
NPI assigned
May 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 4555 OH Primary

Addresses

Primary practice location

1670 Upham Dr
Columbus, OH 43210-1250

Mailing address

1670 Upham Dr.
Columbus, OH 43210-1250
Phone (614) 293-9600

Other identifiers 1

IdentifierTypeStateIssuer
0880659MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4555OHMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Behavioral Health LLC Past Accepting new patients
Beth T. McCreary, PHD, LLC Past Accepting new patients
Joseph P Decola, PH.D., LLC Past Accepting new patients
Ohio State University Past Accepting new patients

Organizations & group practices 4

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": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255996800000",
    "number": "1891753554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1670 UPHAM DR.",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101250",
            "telephone_number": "614-293-9600",
            "fax_number": "614-293-9467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1670 UPHAM DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101250",
            "telephone_number": "614-293-9600",
            "fax_number": "614-293-9467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAULUS",
        "first_name": "JOHN",
        "middle_name": "A",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2009-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OH",
            "license": "4555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0880659",
            "state": "OH"
        }
    ],
    "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 Oct 20, 2009; 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.