Johnny J Abidin, MD
Individual provider Active NPI Internal Medicine Physician · Lancaster, OH
NPI 1902885403 · NPPES record last updated Jul 23, 2012
Key facts
- NPI
- 1902885403
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 35067115A (OH)
- Practice address
- 135 N Ewing St
Suite 305
Lancaster, OH 43130-3382 - Phone
- (740) 681-9447
- Fax
- (740) 681-9966
- NPI assigned
- Jan 12, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110119000015 | OH | Practitioner - Internal Medicine | 5395771257 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35067115A | OH | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Ohio Primary Care Physicians, Inc. | Internal Medicine | Current |
Accepting new patients |
| Central Ohio Primary Care Physicians Inc | Current | Accepting new patients | |
| Central Ohio Primary Care Physicians, Inc. | Current |
Accepting new patients | |
| Lima Memorial Joint Operating Company | Past | Accepting new patients |
Locations
4885 Olentangy River Rd
Columbus, OH 43214
Phone (614) 326-5665
135 N Ewing St
Ste 305
Lancaster, OH 43130
Phone (740) 681-9447
Interoperability endpoints
- jabidin19062@copcp.medicity.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 35067115A | OH | Yes |
Addresses
Primary practice location
135 N Ewing St
Suite 305
Lancaster, OH 43130-3382
Mailing address
135 N Ewing St
Suite 305
Lancaster, OH 43130-3382
Phone (740) 681-9447
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0157717 | Medicaid | OH |
Other providers in Lancaster, OH
- 800 Becks Knob Road Opco LLC
- A Brighter Path, LLC
- A Creative Journey
- A Followed Path, LLC
- Shawna Abbott
- Jason M Abram
- Kathleen Marie Abram
- Absolute Home Healthcare, LLC
- Alissa V Ackelson
- Janice Adamah-Tassah
All providers in Lancaster, OH · Internal Medicine Physician in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 23, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.