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EVERSIDE HEALTH AT NTN COLUMBUS W GOELLER NPI 1811678493


NPI Information

NPI: 1811678493
Provider Name: EVERSIDE HEALTH AT NTN COLUMBUS W GOELLER
Classification: Preventive Medicine - 2083P0500X
Entity Type: Organization

Specialization: Preventive Medicine/Occupational Environmental Medicine

CLIA Number: 15D2289228

Address:
4010 W GOELLER BLVD
COLUMBUS, IN
ZIP 47201
Phone: (704) 661-1380
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EVERSIDE HEALTH AT NTN COLUMBUS W GOELLER is a preventive medicine/occupational environmental medicine preventive medicine in Columbus, IN. The provider is a preventive medicine physician who specializes in preventive medicine/occupational-environmental medicine, which is focused on protecting the population from occupational and environmental conditions. EVERSIDE HEALTH AT NTN COLUMBUS W GOELLER NPI is 1811678493. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4010 W GOELLER BLVD
COLUMBUS, IN
ZIP 47201-307
Phone: (704) 661-1380

The provider's authorized official is Jill Johnson Patton .
The authorized official title is Director Of Risk Management and has the following contact phone number (704) 936-5546.

The CLIA number assigned to this NPI record is 15D2289228 - other - chronic mgt with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/27/2023 and was last updated on 7/27/2023.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12083P0500XPreventive MedicinePreventive Medicine/Occupational Environmental MedicineYes

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: 5/5/2024

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