Organization Active NPI

Mid Ohio Neurology, Inc

  • Specialist
  • Newark, OH
National Provider Identifier
1992890545
Registry record updated Aug 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
MID OHIO NEUROLOGY, INC
Practice address
1916 Tamarack Rd
Newark, OH 43055-2303
Phone
(740) 522-6110
Fax
(740) 522-0126
NPI assigned
Oct 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2024

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

Authorized official

Name
Dr. Mourad Abdelmessih, M.D.NPI 1184628950
Title
Owner
Phone
(740) 522-6110

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
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

1916 Tamarack Rd
Newark, OH 43055-2303

Mailing address

1916 Tamarack Rd
Newark, OH 43055-2303
Phone (740) 522-6110

Other identifiers 4

IdentifierTypeStateIssuer
000000314455OtherANTHEM GROUP NUMBER
2431167MedicaidOH
DA5551OtherOHMEDICARE RAILROAD GROUP
0811063OtherNEUROLOGY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031215000654 OH Part B Supplier - Clinic/Group Practice 3274430608 Receives reassigned benefits from 4 practitioners
Practice locations: Newark, OH

National Provider Directory

National Provider Directory

Locations

1916 Tamarack Rd
Newark, OH 43055
Phone (740) 349-2978

Practitioners & affiliated clinicians

Practitioners 5

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": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723593600000",
    "number": "1992890545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1916 TAMARACK RD",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430552303",
            "telephone_number": "740-522-6110",
            "fax_number": "740-522-0126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1916 TAMARACK RD",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430552303",
            "telephone_number": "740-522-6110",
            "fax_number": "740-522-0126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID OHIO NEUROLOGY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A",
        "authorized_official_last_name": "ABDELMESSIH",
        "authorized_official_first_name": "MOURAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "740-522-6110",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM GROUP NUMBER",
            "identifier": "000000314455",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2431167",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD GROUP",
            "identifier": "DA5551",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEUROLOGY",
            "identifier": "0811063",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2024; 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.