Nicholas Vito Landry, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

34006760 Issued in OH

Practice address

1354 Jackson Pike
Gallipolis, OH 45631-2601

Phone

(740) 441-9800

Fax

(740) 441-9400

NPI assigned

Dec 15, 2005

Last updated

Jun 7, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Ohio University, College of Osteopathic Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Holzer Medical Center Hospital, Gallipolis, OH, CCN 360054
• Adena Regional Medical Center Hospital, Chillicothe, OH, CCN 360159

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Nicholas Landry D.O. Inc.

  • Family Medicine Physician
  • Gallipolis, OH
  • NPI 1508967910
  Medicare reassignment Authorized official
• Medical Service Options Inc

  dba Comprehensive Addiction Care Centers

  • Community/Behavioral Health Agency
  • Gallipolis, OH
  • NPI 1417377797
  NPD (past) Authorized official
• Medical Service Options Inc

  dba Community Counseling and Social Services

  • Community/Behavioral Health Agency
  • Wellston, OH
  • NPI 1629498951
  Authorized official Same address or phone

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Adena Health System

  dba Adena Regional Medical Center

  • General Acute Care Hospital
  • Chillicothe, OH
  • NPI 1902839673
  Care Compare affiliation
• Holzer Hospital Foundation

  • Rural Acute Care Hospital
  • Gallipolis, OH
  • NPI 1942256888
  Care Compare affiliation

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

{
    "created_epoch": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559865600000",
    "number": "1992781538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 NORTHUP RD",
            "city": "GALLIPOLIS",
            "state": "OH",
            "postal_code": "456318830",
            "telephone_number": "740-441-9800",
            "fax_number": "740-441-9400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1354 JACKSON PIKE",
            "city": "GALLIPOLIS",
            "state": "OH",
            "postal_code": "456312601",
            "telephone_number": "740-441-9800",
            "fax_number": "740-441-9400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "407 S 3rd St",
            "address_purpose": "LOCATION",
            "city": "Ironton",
            "state": "OH",
            "postal_code": "456381730",
            "country_code": "US",
            "telephone_number": "740-534-1200",
            "fax_number": "740-534-1202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANDRY",
        "first_name": "NICHOLAS",
        "middle_name": "VITO",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-15",
        "last_updated": "2019-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34006760",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7108004",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL MUTUAL OF OMAHA",
            "identifier": "340066272007",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORESOURCE",
            "identifier": "300147896027",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2144067",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL MUTUAL OF OHIO",
            "identifier": "340066272001",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000303053",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5630097000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kenneth Kyger, DDS
• Timothy Virgil Kyger, D.D.S.
• Jennifer Lackey, PH.D.
• Lucinda Lambert, CRISIS RES SPEC
• Lindsey Michelle Landrum, CDCA
• Aubrey Devin Lane, D.C.
• Terrence E Lane
• Beth Ann Lanier, MA
• Loretta L. Lauder, AUD
• Brandon Lawson

• Family Medicine Physician in Gallipolis, OH
• Providers in Gallipolis, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.