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NORTHRIDGE FAMILY PRACTICE LLC NPI 1669453189


NPI Information

NPI: 1669453189
Provider Name: NORTHRIDGE FAMILY PRACTICE LLC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 36D0328232

Address:
610 NORTHRIDGE RD
CIRCLEVILLE, OH
ZIP 43113
Phone: (740) 474-3159
Get Directions

NORTHRIDGE FAMILY PRACTICE LLC is a family medicine in Circleville, OH. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. NORTHRIDGE FAMILY PRACTICE LLC NPI is 1669453189. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

610 NORTHRIDGE RD
CIRCLEVILLE, OH
ZIP 43113
Phone: (740) 474-3159
Fax: (740) 474-2110

The provider's authorized official is Deborah Lea Lewis .
The authorized official title is Office Manager and has the following contact phone number (740) 474-3159.

The CLIA number assigned to this NPI record is 36D0328232 - practitioner other with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 11/10/2005 and was last updated on 12/11/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily Medicine35071002JOHIONo
2207Q00000XFamily Medicine350463858OHIONo
3207Q00000XFamily Medicine35053974MOHIONo
4207Q00000XFamily Medicine35042158BOHIOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
12211430MEDICAIDOHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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