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13234 Durham Cir Pickerington OH 43147-8330 | |
| (614) 595-2077 | |
| (614) 322-2883 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 13234 Durham Cir, Pickerington, Ohio |
| Authorized Official Name and Position | Stephen Mcallister (OWNER/NP) |
| Authorized Official Contact | 6145952077 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
13234 Durham Cir Pickerington OH 43147-8330 Ph: (614) 595-2077 | 13234 Durham Cir Pickerington OH 43147-8330 Ph: (614) 595-2077 |
| NPI Number | 1639898067 |
|---|---|
| Provider Enumeration Date | 08/29/2022 |
| Last Update Date | 01/07/2023 |
| Certification Date | 01/07/2023 |
| Medicare PECOS PAC ID | 6204201452 |
|---|---|
| Medicare Enrollment ID | O20230331001551 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639898067 | NPI | - | NPPES |
| 1790133890 | Medicaid | OH | |
| 0460293 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Stephen C Mcallister |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790133890 PECOS PAC ID: 6800293606 Enrollment ID: I20210921003039 |
| Provider Name | Kristin Mcallister |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881105435 PECOS PAC ID: 3375936511 Enrollment ID: I20220210000851 |
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