Organization Active NPI

Dr Kewa Li MD Inc

  • Internal Medicine Physician
  • Columbus, OH
National Provider Identifier
1982793733
Registry record updated Jun 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35079470 Issued in OH
Legal business name
DR KEWA LI MD INC
Practice address
2931 Donnylane Blvd
Columbus, OH 43235-3228
Phone
(614) 760-0622
Fax
(614) 760-0610
NPI assigned
Oct 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2010

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

Authorized official

Name
Kewa Li, MDNPI 1104896711
Title
Owner
Phone
(614) 760-0622

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 35079470 OH Primary

Addresses

Primary practice location

2931 Donnylane Blvd
Columbus, OH 43235-3228

Mailing address

PO Box 635493
Cincinnati, OH 45263-5493
Phone (614) 451-8770

Other identifiers 2

IdentifierTypeStateIssuer
2814413MedicaidOH
DF7242OtherOHRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060321000651 OH Part B Supplier - Clinic/Group Practice 8123035896 Receives reassigned benefits from 1 practitioner
Practice locations: Columbus, OH

National Provider Directory

National Provider Directory

Locations

2931 Donnylane Blvd
Columbus, OH 43235
Phone (614) 760-0622

Practitioners & affiliated clinicians

Practitioners 2

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": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275609600000",
    "number": "1982793733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 635493",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452635493",
            "telephone_number": "614-451-8770",
            "fax_number": "614-451-2291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2931 DONNYLANE BLVD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432353228",
            "telephone_number": "614-760-0622",
            "fax_number": "614-760-0610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR KEWA LI MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2010-06-04",
        "status": "A",
        "authorized_official_last_name": "LI",
        "authorized_official_first_name": "KEWA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "614-760-0622",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35079470",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2814413",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DF7242",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.