NPIMap

Organization Active NPI

Lodi Medical Group Inc.

  • Internal Medicine Physician
  • Lodi, OH
National Provider Identifier
1932329414
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35033396 Issued in OH
Legal business name
LODI MEDICAL GROUP INC.
Practice address
402 Highland Dr
Lodi, OH 44254-1216
Phone
(330) 948-1555
Fax
(330) 948-2676
NPI assigned
Apr 26, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Graciano B Dichoso, M.D.NPI 1730255670
Title
Owner
Phone
(330) 948-1555

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35033396 OH Primary

Addresses

Primary practice location

402 Highland Dr
Lodi, OH 44254-1216

Mailing address

402 Highland Dr
Lodi, OH 44254-1216
Phone (330) 948-1555

Other identifiers 1

IdentifierTypeStateIssuer
0185508MedicaidOH

National Provider Directory

National Provider Directory

Locations

402 Highland Dr
Lodi, OH 44254
Phone (330) 948-1555

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1932329414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 HIGHLAND DR",
            "city": "LODI",
            "state": "OH",
            "postal_code": "442541216",
            "telephone_number": "330-948-1555",
            "fax_number": "330-948-2676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 HIGHLAND DR",
            "city": "LODI",
            "state": "OH",
            "postal_code": "442541216",
            "telephone_number": "330-948-1555",
            "fax_number": "330-948-2676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LODI MEDICAL GROUP INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DICHOSO",
        "authorized_official_first_name": "GRACIANO",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "330-948-1555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35033396",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0185508",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lodi, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.