Healthserve Medical Group LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

HEALTHSERVE MEDICAL GROUP LLC

Practice address

445 Rocky Fork Blvd Ste a
Gahanna, OH 43230-3336

Phone

(614) 442-2431

Fax

(614) 442-2426

NPI assigned

Oct 13, 2014

Last updated

Oct 13, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michael C Bourland

Title

President

Phone

(614) 442-2431

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1413158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413158400000",
    "number": "1962806570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2939 KENNY RD STE 200",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432212406",
            "telephone_number": "614-442-2431",
            "fax_number": "614-442-2426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 ROCKY FORK BLVD STE A",
            "city": "GAHANNA",
            "state": "OH",
            "postal_code": "432303336",
            "telephone_number": "614-442-2431",
            "fax_number": "614-442-2426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHSERVE MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-13",
        "last_updated": "2014-10-13",
        "status": "A",
        "authorized_official_last_name": "BOURLAND",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "614-442-2431"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUSINESS LICENSE",
            "identifier": "153534",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Gahanna, OH
• Providers in Gahanna, OH by specialty
• Physical Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2014; 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.