| Columbus Physicians Group Llc | |
|
4995 Bradenton Ave Ste 110 Dublin OH 43017-3551 | |
| (614) 515-2500 | |
| (614) 573-0530 |
| Full Name | Columbus Physicians Group Llc |
|---|---|
| Speciality | Pain Medicine |
| Location | 4995 Bradenton Ave Ste 110, Dublin, Ohio |
| Authorized Official Name and Position | Heather Gore (CEO) |
| Authorized Official Contact | 6145152500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Columbus Physicians Group Llc 4995 Bradenton Ave Ste 110 Dublin OH 43017-3551 Ph: (614) 515-2500 | Columbus Physicians Group Llc 4995 Bradenton Ave Ste 110 Dublin OH 43017-3551 Ph: (614) 515-2500 |
| NPI Number | 1467239616 |
|---|---|
| Provider Enumeration Date | 09/12/2023 |
| Last Update Date | 06/10/2025 |
| Certification Date | 06/10/2025 |
| Medicare PECOS PAC ID | 9234589409 |
|---|---|
| Medicare Enrollment ID | O20231229002419 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467239616 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Secondary |
| 208VP0014X | Pain Medicine - Interventional Pain Medicine | (* (Not Available)) | Primary |
| Provider Name | Krishna Deshpande |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1730100413 PECOS PAC ID: 0345245734 Enrollment ID: I20060918000294 |
| Provider Name | Katherine M Covault |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1255663456 PECOS PAC ID: 5799930780 Enrollment ID: I20130222000416 |
| Provider Name | Heather Kay Sheline |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487249777 PECOS PAC ID: 4688083348 Enrollment ID: I20210510001007 |
| Provider Name | Douglas Moinuddin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750907051 PECOS PAC ID: 1355717422 Enrollment ID: I20221013002558 |
| Provider Name | Elizabeth Anne Paparodis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619682168 PECOS PAC ID: 6507223625 Enrollment ID: I20230606000598 |
| Provider Name | Courtney Keating |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568140036 PECOS PAC ID: 9638533565 Enrollment ID: I20230912000746 |
| Provider Name | Amanda Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336915834 PECOS PAC ID: 7810439809 Enrollment ID: I20240605002689 |
| Provider Name | Kimberly Watts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124899646 PECOS PAC ID: 6406382209 Enrollment ID: I20241203003967 |
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