NPIMap

Organization Active NPI

Medcosmetix, LLC

  • Family Medicine Physician
  • Marion, OH
National Provider Identifier
1891960720
Registry record updated Apr 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35051305G Issued in OH
Legal business name
MEDCOSMETIX, LLC
Practice address
241 Executive Dr
Marion, OH 43302-6307
Phone
(740) 387-3256
Fax
(740) 383-4906
NPI assigned
Apr 22, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2008

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

Authorized official

Name
Dr. Timothy Francis Garner, M.D.
Title
President
Phone
(740) 387-3256

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 35051305G OH Primary

Addresses

Primary practice location

241 Executive Dr
Marion, OH 43302-6307

Mailing address

241 Executive Dr
Marion, OH 43302-6307
Phone (740) 387-3256

Other identifiers 1

IdentifierTypeStateIssuer
0695805MedicaidOH

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1208822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208822400000",
    "number": "1891960720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "241 EXECUTIVE DR",
            "city": "MARION",
            "state": "OH",
            "postal_code": "433026307",
            "telephone_number": "740-387-3256",
            "fax_number": "740-383-4906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "241 EXECUTIVE DR",
            "city": "MARION",
            "state": "OH",
            "postal_code": "433026307",
            "telephone_number": "740-387-3256",
            "fax_number": "740-383-4906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDCOSMETIX, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-22",
        "last_updated": "2008-04-22",
        "status": "A",
        "authorized_official_last_name": "GARNER",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "FRANCIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "740-387-3256",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35051305G",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0695805",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 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.