NPIMap

Organization Active NPI

Magnolia Medical Company

Doing business as Magnolia Medical Group

  • Addiction Medicine (Family Medicine) Physician
  • Shawnee Hills, OH
National Provider Identifier
1952094476
Registry record updated May 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X
Legal business name
MAGNOLIA MEDICAL COMPANY
Doing business as
Magnolia Medical Group
Practice address
9572 Dublin Rd
Shawnee Hills, OH 43065-8973
Phone
(303) 209-5115
Fax
(833) 603-0135
NPI assigned
May 31, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 31, 2023

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

Authorized official

Name
Susie Lerner
Title
Revenue Cycle Manager
Phone
(720) 909-3890

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Family Medicine) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207QA0401X Primary

Addresses

Primary practice location

9572 Dublin Rd
Shawnee Hills, OH 43065-8973

Mailing address

2925 E Colfax Ave
Denver, CO 80206-1604
Phone (303) 209-5115

Other names 1

  • Magnolia Medical Group Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Magnolia Medical Group4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

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": "1685491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685491200000",
    "number": "1952094476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 E COLFAX AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802061604",
            "telephone_number": "303-209-5115",
            "fax_number": "833-603-0135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9572 DUBLIN RD",
            "city": "SHAWNEE HILLS",
            "state": "OH",
            "postal_code": "430658973",
            "telephone_number": "303-209-5115",
            "fax_number": "833-603-0135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA MEDICAL COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-31",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A",
        "authorized_official_last_name": "LERNER",
        "authorized_official_first_name": "SUSIE",
        "authorized_official_title_or_position": "REVENUE CYCLE MANAGER",
        "authorized_official_telephone_number": "720-909-3890"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Magnolia Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shawnee Hills, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2023; 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.