| Ohio State University - Cap | |
|
3870 Townsfair Way # 103-b Columbus OH 43219-6173 | |
| (888) 663-6331 | |
| (380) 223-2984 |
| Full Name | Ohio State University - Cap |
|---|---|
| Speciality | Internal Medicine |
| Location | 3870 Townsfair Way # 103-b, Columbus, Ohio |
| Authorized Official Name and Position | Jami Hensley (ADMINISTRATIVE DIRECTOR) |
| Authorized Official Contact | 6142932229 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ohio State University - Cap 700 Ackerman Rd Ste 2120 Columbus OH 43202-1559 Ph: (888) 663-6331 | Ohio State University - Cap 3870 Townsfair Way # 103-b Columbus OH 43219-6173 Ph: (888) 663-6331 |
| NPI Number | 1669047924 |
|---|---|
| Provider Enumeration Date | 05/20/2021 |
| Last Update Date | 11/19/2024 |
| Medicare PECOS PAC ID | 3375434707 |
|---|---|
| Medicare Enrollment ID | O20040323001973 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669047924 | NPI | - | NPPES |
| 2043158 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 208000000X | Pediatrics | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Kellie Greene |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821420795 PECOS PAC ID: 6204079494 Enrollment ID: I20130909000502 |
| Provider Name | Latisha M Fowler |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1275850760 PECOS PAC ID: 1557646775 Enrollment ID: I20170330000150 |
| Provider Name | Chelsea Lee Willis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942655154 PECOS PAC ID: 7315232105 Enrollment ID: I20190925002652 |
| Provider Name | Thomas Nguyen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144282880 PECOS PAC ID: 8628251899 Enrollment ID: I20211209002095 |
| Provider Name | Constance Quinn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720145154 PECOS PAC ID: 0446359905 Enrollment ID: I20250110002640 |
| Provider Name | James Leonard Lyda |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1508012501 PECOS PAC ID: 7719305747 Enrollment ID: I20250212000193 |
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