Organization Active NPI

Donnalyn Moeller, DPM,Inc

  • Podiatrist
  • Columbus, OH
National Provider Identifier
1992922124
Registry record updated Jun 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
36002995 Issued in OH
Legal business name
DONNALYN MOELLER, DPM,INC
Practice address
3131 W Broad St
Columbus, OH 43204-1306
Phone
(614) 272-8854
Fax
(614) 272-9200
NPI assigned
Apr 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2015

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

Authorized official

Name
Dr. Donnalyn Moeller, DPMNPI 1568456630
Title
President
Phone
(614) 272-8854

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
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X 36002995 OH Primary

Addresses

Primary practice location

3131 W Broad St
Columbus, OH 43204-1306

Mailing address

3131 W Broad St
Columbus, OH 43204-1306
Phone (614) 272-8854

Other identifiers 2

IdentifierTypeStateIssuer
2791573MedicaidOH
DN0823OtherOHRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20071106000385 OH Part B Supplier - Clinic/Group Practice 6901993047 Receives reassigned benefits from 1 practitioner
Practice locations: Columbus, OH
O20100930061776 OH DME Supplier - Physician - Podiatry 6901993047 Practice locations: Columbus, OH

National Provider Directory

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.

NPI Registry JSON

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434931200000",
    "number": "1992922124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3131 W BROAD ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432041306",
            "telephone_number": "614-272-8854",
            "fax_number": "614-272-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 W BROAD ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432041306",
            "telephone_number": "614-272-8854",
            "fax_number": "614-272-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DONNALYN MOELLER, DPM,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-19",
        "last_updated": "2015-06-22",
        "status": "A",
        "authorized_official_last_name": "MOELLER",
        "authorized_official_first_name": "DONNALYN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "614-272-8854",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "OH",
            "license": "36002995",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2791573",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DN0823",
            "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 22, 2015; 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.