Organization Active NPI

Central Ohio Endoscopy Center, LLC

  • Endoscopy Clinic/Center
  • Westerville, OH
National Provider Identifier
1902431646
Registry record updated Oct 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endoscopy Clinic/CenterTaxonomy code 261QE0800X
Legal business name
CENTRAL OHIO ENDOSCOPY CENTER, LLC
Practice address
430 Altair Pkwy Ste 120
Westerville, OH 43082-7647
Phone
(614) 754-5500
Fax
(614) 754-5501
NPI assigned
Mar 3, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2025

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

Authorized official

Name
Bruce L Hennessy, MDNPI 1891788386
Title
Manager
Phone
(614) 754-5500

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X
Endoscopy Clinic/Center 261QE0800X Primary

Addresses

Primary practice location

430 Altair Pkwy Ste 120
Westerville, OH 43082-7647

Mailing address

3400 Olentangy River Rd
Columbus, OH 43202-1523
Phone (614) 754-5500

Other identifiers 1

IdentifierTypeStateIssuer
0472352MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ohio.gastro@oggi.eclinicaldirectplus.com Direct Ohio Gastroenterology Group, Inc.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250929001905 OH Part B Supplier - Ambulatory Surgical Center 2860553120 Practice locations: Westerville, OH

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Central Ohio Endoscopy Center LLCCCN 36C0001340
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D2180382Central Ohio Endoscopy Center, LLC430 Altair Parkway, Westerville, OH 43082Certificate of waiverMar 11, 2028

National Provider Directory

National Provider Directory
Tax ID family
Central Ohio Endoscopy Center LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

85 McNaughten Rd
Columbus, OH 43213
Phone (614) 863-1611

815 W Broad St
Ste 220
Columbus, OH 43222
Phone (614) 799-0822

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1583193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759708800000",
    "number": "1902431646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 OLENTANGY RIVER RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021523",
            "telephone_number": "614-754-5500",
            "fax_number": "614-457-9519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 ALTAIR PKWY STE 120",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430827647",
            "telephone_number": "614-754-5500",
            "fax_number": "614-754-5501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL OHIO ENDOSCOPY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-03",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A",
        "authorized_official_last_name": "HENNESSY",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "614-754-5500",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QE0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Endoscopy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0472352",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ohio.gastro@oggi.eclinicaldirectplus.com",
            "affiliation": "Y",
            "endpointDescription": "eClinicalDirect LLC, an EHNAC-DTAAP accredited HISP",
            "affiliationName": "Ohio Gastroenterology Group, Inc.",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "XML.XML",
            "address_1": "430 Altair Pkwy Ste 120",
            "city": "Westerville",
            "state": "OH",
            "country_code": "US",
            "postal_code": "430827647",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Westerville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.