Active NPI 1356303481 Individual Practitioner Male Practitioner

Dr. Brad Lang Bernacki , MD

Orthopaedic Surgery • Granville, OH

✓ Accepts Medicare Assignment

Public Directory Information & Medical Disclaimer

This profile is compiled from official public domain records provided by CMS and the NPPES registry. TRUE-MEDINFO is an independent reference directory and does not provide medical advice, diagnosis, or treatment recommendations. Always consult a licensed medical professional for personal health decisions.

Professional Overview & Biography Verified Profile Summary

Dr. Brad Bernacki, MD is a registered Orthopaedic Surgery practitioner in Granville, OH. With approximately 26 years of clinical practice since graduating from Ohio State University College Of Medicine in 2000, Dr. Bernacki provides healthcare services at the registered practice location at 2750 NEWARK GRANVILLE RD.

Dr. Bernacki is affiliated with Beacon Orthopaedics And Sports Medicine Ltd and accepts Medicare assignment.

Frequently performed procedures and clinical services include injection, triamcinolone acetonide, not otherwise specified, 10 mg, established patient outpatient office visit, aspiration and/or injection of fluid from large joint. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

2750 Newark Granville Rd

Granville, OH 430239142

Telephone 7407889220

Fax 7407889226

Associated Practice Facility / Clinic

🏢 Orthopedic Specialists & Sports Medicine, Inc. Facility NPI 1710983200

Medicare Profile & Education

Medical School

Ohio State University College Of Medicine

Graduation Year

2000

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Orthopaedic Surgery in Granville, OH

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

26 Yrs +4.7 yrs vs City Avg

City Avg: 21.3 Yrs

State Avg: 25.4 Yrs

Regional Practice Density

4 Specialists

Practicing in Granville, OH (984 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

69.2% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Bernacki (26 Years) 26 Yrs

Granville Specialty Average (21.3 Years) 21.3 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	1,209	123	$6.00	$0.97
99213 Established patient office or other outpatient visit, typically 15 minutes	231	127	$150.00	$84.15
20610 Aspiration and/or injection of fluid from large joint	109	68	$226.61	$65.17
20552 Injections of trigger points in 1 or 2 muscles	83	57	$157.98	$43.01
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	65	57	$183.03	$117.49
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	39	39	$200.00	$103.48
73562 X-ray of knee, 3 views	38	35	$114.95	$41.16
20550 Injection into tendon or ligament	33	27	$173.79	$49.96
73721 Mri scan of leg joint without contrast	29	28	$900.00	$127.19
73030 X-ray of shoulder, minimum of 2 views	24	24	$83.25	$35.76
72100 X-ray of lower and sacral spine, 2-3 views	22	20	$99.00	$28.53
20605 Aspiration and/or injection of medium joint or joint capsule	22	20	$178.59	$55.37
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	17	17	$276.00	$156.73
73502 X-ray of hip, 2-3 views	17	16	$68.00	$43.10
29879 Repair of knee joint using an endoscope	16	16	$1820.00	$632.52
73130 X-ray of hand, minimum of 3 views	14	13	$85.00	$41.16
72148 MRI scan of lower spinal canal	12	12	$900.00	$104.13

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	2,067	170	$6.00	$1.07
99213 Established patient office or other outpatient visit, typically 15 minutes	316	170	$150.16	$84.90
20610 Aspiration and/or injection of fluid from large joint	188	104	$255.48	$70.53
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	97	81	$177.31	$120.93
20552 Injections of trigger points in 1 or 2 muscles	85	53	$157.76	$39.45
73562 X-ray of knee, 3 views	68	57	$110.12	$40.29
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	54	54	$200.00	$107.81
73030 X-ray of shoulder, minimum of 2 views	46	35	$74.00	$32.54
20550 Injection into tendon or ligament	39	32	$158.97	$51.14
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	37	37	$276.00	$160.55
73721 Mri scan of leg joint without contrast	37	36	$900.00	$127.48
20605 Aspiration and/or injection of medium joint or joint capsule	33	18	$137.03	$45.88
29879 Repair of knee joint using an endoscope	27	25	$1820.00	$634.26
20600 Aspiration and/or injection of fluid from small joint	27	21	$157.63	$44.25
72100 X-ray of lower and sacral spine, 2-3 views	23	23	$99.00	$36.63
73630 X-ray of foot, minimum of 3 views	23	19	$73.04	$33.58
73221 Mri scan of arm joint without contrast	19	18	$900.00	$127.60
73502 X-ray of hip, 2-3 views	19	16	$68.00	$44.05
73610 X-ray of ankle, minimum of 3 views	17	15	$71.00	$34.63
29881 Removal of knee cartilage using an endoscope	16	13	$2360.00	$127.52
29876 Removal of joint lining from multiple knee joint compartments using an endoscope	15	12	$2360.00	$267.17
73110 X-ray of wrist, minimum of 3 views	15	12	$73.00	$38.34
72148 MRI scan of lower spinal canal	13	13	$900.00	$114.03
73130 X-ray of hand, minimum of 3 views	13	13	$75.38	$37.29
29880 Removal of both knee cartilages using an endoscope	13	13	$3539.00	$182.98

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	1,096	122	$10.10	$1.11
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	187	132	$183.00	$123.05
20610 Aspiration and/or injection of fluid from large joint	145	92	$161.90	$65.81
99213 Established patient office or other outpatient visit, typically 15 minutes	80	63	$136.03	$86.34
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	80	80	$281.00	$162.92
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	50	44	$247.00	$169.82
73560 X-ray of knee, 1-2 views	40	39	$75.90	$39.01
73565 X-ray of both knees while standing	39	39	$68.00	$38.47
73721 Mri scan of leg joint without contrast	34	32	$529.18	$133.30
20552 Injections of trigger points in 1 or 2 muscles	31	21	$124.61	$41.32
73030 X-ray of shoulder, minimum of 2 views	27	26	$67.04	$35.33
73130 X-ray of hand, minimum of 3 views	26	26	$81.38	$37.33
73502 X-ray of hip, 2-3 views	23	20	$86.26	$44.60
29879 Repair of knee joint using an endoscope	22	20	$1498.32	$610.97
73221 Mri scan of arm joint without contrast	21	20	$524.76	$138.30
29876 Removal of joint lining from multiple knee joint compartments using an endoscope	21	19	$1515.24	$234.01
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	20	20	$188.00	$108.31
20605 Aspiration and/or injection of medium joint or joint capsule	18	12	$114.67	$42.90
72148 MRI scan of lower spinal canal	18	17	$525.78	$109.80
73630 X-ray of foot, minimum of 3 views	16	15	$67.88	$34.87
72100 X-ray of lower and sacral spine, 2-3 views	16	16	$76.50	$37.97
73110 X-ray of wrist, minimum of 3 views	16	13	$79.56	$40.91
20550 Injection into tendon or ligament	15	14	$132.40	$50.34
29881 Removal of knee cartilage using an endoscope	12	11	$1304.92	$125.90

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	1,368	173	$10.98	$1.25
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	348	197	$184.58	$125.43
20610 Aspiration and/or injection of fluid from large joint	223	131	$135.80	$64.73
73560 X-ray of knee, 1-2 views	119	86	$66.00	$32.99
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	115	115	$281.00	$163.08
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	91	82	$247.00	$171.11
73565 X-ray of both knees while standing	88	83	$68.00	$38.31
73721 Mri scan of leg joint without contrast	59	45	$506.00	$136.46
73030 X-ray of shoulder, minimum of 2 views	44	36	$62.00	$32.37
73502 X-ray of hip, 2-3 views	38	32	$88.00	$44.39
73130 X-ray of hand, minimum of 3 views	38	29	$66.00	$38.60
29879 Repair of knee joint using an endoscope	33	30	$1483.00	$601.22
29876 Removal of joint lining from multiple knee joint compartments using an endoscope	32	29	$1473.00	$239.90
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	29	27	$352.00	$197.58
20605 Aspiration and/or injection of medium joint or joint capsule	28	20	$111.00	$55.67
73110 X-ray of wrist, minimum of 3 views	24	21	$78.13	$38.75
20550 Injection into tendon or ligament	24	21	$117.00	$54.21
72100 X-ray of lower and sacral spine, 2-3 views	23	22	$75.00	$36.63
73221 Mri scan of arm joint without contrast	22	19	$506.00	$141.63
29881 Removal of knee cartilage using an endoscope	21	19	$1209.00	$132.33
99213 Established patient office or other outpatient visit, typically 15 minutes	21	19	$124.00	$89.39
20552 Injections of trigger points in 1 or 2 muscles	21	14	$121.00	$40.11
73610 X-ray of ankle, minimum of 3 views	20	14	$67.00	$34.92
73630 X-ray of foot, minimum of 3 views	18	16	$62.00	$34.34
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	16	16	$354.00	$204.99

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	1,313	180	$11.00	$1.45
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	411	227	$183.00	$106.41
20610 Aspiration and/or injection of fluid from large joint	226	141	$135.78	$65.85
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	108	108	$281.00	$157.62
73560 X-ray of knee, 1-2 views	105	66	$66.00	$31.89
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	77	64	$248.39	$139.17
73565 X-ray of both knees while standing	64	59	$68.00	$36.29
73030 X-ray of shoulder, minimum of 2 views	51	44	$62.00	$32.66
73502 X-ray of hip, 2-3 views	48	37	$88.00	$43.03
99213 Established patient office or other outpatient visit, typically 15 minutes	35	35	$124.00	$73.61
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	30	29	$352.00	$202.76
20605 Aspiration and/or injection of medium joint or joint capsule	28	18	$111.00	$44.28
73221 Mri scan of arm joint without contrast	28	27	$506.00	$142.89
72100 X-ray of lower and sacral spine, 2-3 views	28	28	$75.00	$36.45
73721 Mri scan of leg joint without contrast	27	25	$506.00	$129.59
73130 X-ray of hand, minimum of 3 views	25	24	$66.00	$34.62
20550 Injection into tendon or ligament	24	21	$117.00	$51.16
73110 X-ray of wrist, minimum of 3 views	24	21	$75.00	$40.37
73630 X-ray of foot, minimum of 3 views	21	17	$62.00	$31.20
72148 MRI scan of lower spinal canal	21	21	$479.00	$117.73
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	20	20	$354.00	$205.27
20552 Injections of trigger points in 1 or 2 muscles	20	15	$121.00	$49.82
29879 Repair of knee joint using an endoscope	18	18	$1483.00	$641.44
73610 X-ray of ankle, minimum of 3 views	17	15	$67.00	$35.19
29876 Removal of joint lining from multiple knee joint compartments using an endoscope	17	17	$1473.00	$239.54
29881 Removal of knee cartilage using an endoscope	12	12	$1209.00	$125.82

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	1,396	193	$11.00	$1.59
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	399	241	$183.00	$104.95
20610 Aspiration and/or injection of fluid from large joint	223	146	$140.01	$63.38
73560 X-ray of knee, 1-2 views	131	87	$66.00	$32.69
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	110	85	$247.00	$140.07
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	100	100	$281.00	$159.40
73565 X-ray of both knees while standing	96	80	$69.42	$34.50
73030 X-ray of shoulder, minimum of 2 views	53	47	$62.00	$31.33
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	47	47	$354.00	$202.28
73721 Mri scan of leg joint without contrast	43	37	$506.00	$145.65
73502 X-ray of hip, 2-3 views	41	35	$88.00	$40.63
73221 Mri scan of arm joint without contrast	34	32	$506.00	$147.55
20605 Aspiration and/or injection of medium joint or joint capsule	31	21	$111.00	$45.77
72100 X-ray of lower and sacral spine, 2-3 views	28	28	$75.00	$33.63
73130 X-ray of hand, minimum of 3 views	27	25	$66.00	$35.08
20550 Injection into tendon or ligament	26	22	$117.00	$53.84
73630 X-ray of foot, minimum of 3 views	26	23	$62.00	$31.87
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	24	23	$352.00	$200.39
99213 Established patient office or other outpatient visit, typically 15 minutes	19	19	$124.00	$72.03
73610 X-ray of ankle, minimum of 3 views	16	15	$67.00	$33.55
20552 Injections of trigger points in 1 or 2 muscles	16	12	$121.00	$47.22
72148 MRI scan of lower spinal canal	15	15	$479.00	$131.07
29879 Repair of knee joint using an endoscope	14	14	$1483.00	$660.93
29876 Removal of joint lining from multiple knee joint compartments using an endoscope	14	14	$1473.00	$248.88
73110 X-ray of wrist, minimum of 3 views	12	11	$75.00	$34.54

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	1,500	191	$11.00	$1.80
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	540	268	$183.00	$99.39
20610 Aspiration and/or injection of fluid from large joint	295	149	$136.27	$57.05
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	169	128	$247.00	$135.31
73560 X-ray of knee, 1-2 views	130	86	$66.00	$31.08
73565 X-ray of both knees while standing	101	90	$68.00	$31.72
73030 X-ray of shoulder, minimum of 2 views	54	45	$62.00	$29.84
20550 Injection into tendon or ligament	52	27	$117.00	$44.02
73502 X-ray of hip, 2-3 views	52	40	$88.00	$37.59
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	50	50	$281.00	$154.34
73721 Mri scan of leg joint without contrast	49	44	$506.00	$138.52
73610 X-ray of ankle, minimum of 3 views	36	27	$67.00	$28.02
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	34	32	$352.00	$192.84
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	34	34	$354.00	$190.32
72100 X-ray of lower and sacral spine, 2-3 views	34	34	$75.00	$31.90
72148 MRI scan of lower spinal canal	34	32	$479.00	$128.37
20605 Aspiration and/or injection of medium joint or joint capsule	32	19	$111.00	$42.76
73221 Mri scan of arm joint without contrast	31	28	$506.00	$144.85
73130 X-ray of hand, minimum of 3 views	26	22	$66.00	$31.16
29876 Removal of joint lining from multiple knee joint compartments using an endoscope	19	18	$1473.00	$279.97
29879 Repair of knee joint using an endoscope	17	16	$1483.00	$632.65
73630 X-ray of foot, minimum of 3 views	16	15	$62.00	$25.36
20551 Injection into tendon at attachment to bone or muscle	16	11	$133.00	$51.55
29821 Removal of entire shoulder joint lining using an endoscope	16	16	$1304.00	$80.82
29826 Shaving of part of shoulder bone and repair of ligament using an endoscope	15	15	$804.00	$150.77
29824 Partial removal of collar bone at shoulder using an endoscope	15	15	$1489.00	$428.37
29823 Removal of extensive shoulder joint tissue using an endoscope	15	15	$1382.00	$86.84
73110 X-ray of wrist, minimum of 3 views	14	11	$75.00	$38.58
27446 Repair of knee joint	13	12	$2490.77	$1042.04
73718 Mri scan of leg without contrast	13	11	$772.00	$184.14
23430 Anchoring of biceps tendon	11	11	$1667.00	$297.96

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	1,386	177	$10.85	$1.78
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	363	223	$185.85	$99.85
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	234	168	$250.13	$132.84
20610 Aspiration and/or injection of fluid from large joint	227	130	$150.78	$60.09
73565 X-ray of both knees while standing	106	93	$96.25	$31.77
73560 X-ray of knee, 1-2 views	101	79	$73.00	$32.37
73030 X-ray of shoulder, minimum of 2 views	76	41	$77.71	$28.42
73721 Mri scan of leg joint without contrast	57	50	$530.05	$145.53
20550 Injection into tendon or ligament	56	37	$119.39	$41.15
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	49	49	$283.16	$153.24
73502 X-ray of hip, 2-3 views	44	35	$91.73	$36.24
29876 Removal of joint lining from multiple knee joint compartments using an endoscope	36	35	$1473.00	$248.65
29879 Repair of knee joint using an endoscope	34	33	$1483.00	$629.18
73610 X-ray of ankle, minimum of 3 views	31	18	$68.03	$27.22
72100 X-ray of lower and sacral spine, 2-3 views	26	25	$75.00	$31.80
73221 Mri scan of arm joint without contrast	26	25	$523.58	$146.76
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	23	23	$363.57	$191.83
73630 X-ray of foot, minimum of 3 views	22	21	$73.05	$29.90
72148 MRI scan of lower spinal canal	22	22	$479.00	$122.93
73562 X-ray of knee, 3 views	21	15	$76.00	$33.85
29881 Removal of knee cartilage using an endoscope	21	20	$1209.00	$120.74
73130 X-ray of hand, minimum of 3 views	16	15	$70.13	$29.63
20605 Aspiration and/or injection of medium joint or joint capsule	16	11	$120.69	$47.89
29880 Removal of both knee cartilages using an endoscope	15	15	$1257.00	$144.08
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	15	15	$354.00	$193.53
23430 Anchoring of biceps tendon	13	13	$1667.00	$353.64
99213 Established patient office or other outpatient visit, typically 15 minutes	12	12	$124.00	$67.70
73110 X-ray of wrist, minimum of 3 views	12	11	$75.00	$29.95
72141 MRI scan of upper spinal canal	11	11	$534.91	$120.66

Medical Specialties & State Licenses

CMS Verified: 2022-04-20

Orthopaedic Surgery Primary Specialty

NUCC Taxonomy Code: 207X00000X

State License OH 35084760

An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

Hospital & Practice Group Affiliations

Beacon Orthopaedics And Sports Medicine Ltd

6480 Harrison Ave, Cincinnati, OH 452477821

Phone: 5133543700

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

10 Associated Practitioners

Thomas Gantner , PA-C

Physician Assistant - Surgical

NPI 1003242298

Physician Assistant (Certified)

Dr. John Quimjian , MD

Orthopaedic Surgery

NPI 1316968746

Doctor of Medicine (M.D.)

Robert Barnes , RNFA

Registered Nurse - Registered Nurse First Assistant

NPI 1437207511

Megan Gordon

Physical Therapist

NPI 1528670510

Dr. David Jackson , MD

Orthopaedic Surgery

NPI 1659392074

Doctor of Medicine (M.D.)

Roberta Giblin , RNFA

Registered Nurse - Registered Nurse First Assistant

NPI 1700934924

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events

📍

Updated Practice Location April 20, 2022

Registered at 2750 NEWARK GRANVILLE RD, GRANVILLE, OH 430239142 (Tel: 7407889220)

📍

Updated Business Mailing Address April 20, 2022

Registered at 2750 NEWARK GRANVILLE RD, GRANVILLE, OH 430239142 (Tel: 7407889220)

✅

NPI Profile Active February 24, 2010

NPI status registered as active in NPPES database

📍

Updated Practice Location February 24, 2010

Registered at 1980 TAMARACK RD, NEWARK, OH 43055 (Tel: 7407889220)

📍

Updated Business Mailing Address February 24, 2010

Registered at 1980 TAMARACK RD, NEWARK, OH 43055 (Tel: 7407889220)

👤

Provider Name / Credentials Updated February 24, 2010

Recorded as BRAD BERNACKI, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) February 24, 2010

Orthopaedic Surgery (License #35084760 in OH)

🟢

Initial NPI Registration & Enumeration April 04, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1356303481

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: April 04, 2006

Last Update: April 20, 2022

Sole Proprietor: No

Update or Correct Profile

Mailing Address

2750 Newark Granville Rd

Granville, OH 430239142

Phone: 7407889220

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.