1497944987 NPI number — MRS. JAMIELYNN WEIS KEMP MPAS,PAC

Table of content: MRS. JAMIELYNN WEIS KEMP MPAS,PAC (NPI 1497944987)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497944987 NPI number — MRS. JAMIELYNN WEIS KEMP MPAS,PAC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KEMP
Provider First Name:
JAMIELYNN
Provider Middle Name:
WEIS
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MPAS,PAC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1497944987
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/02/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
700 ACKERMAN RD
Provider Second Line Business Mailing Address:
STE 570
Provider Business Mailing Address City Name:
COLUMBUS
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43202-1579
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
614-293-2594
Provider Business Mailing Address Fax Number:
614-293-4487

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1654 UPHAM DR
Provider Second Line Business Practice Location Address:
240 DOAN HALL
Provider Business Practice Location Address City Name:
COLUMBUS
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43210-1250
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
614-293-4378
Provider Business Practice Location Address Fax Number:
614-293-7265
Provider Enumeration Date:
10/19/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363A00000X , with the licence number:  50.001900 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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