Provider Demographics
NPI:1316148596
Name:OHIO UNIVERSITY
Entity type:Organization
Organization Name:OHIO UNIVERSITY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN, COORDINATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:NAKANISHI
Authorized Official - Suffix:
Authorized Official - Credentials:RD, LD, CDE
Authorized Official - Phone:740-566-4870
Mailing Address - Street 1:75 HOSPITAL DRIVE SUITE 200
Mailing Address - Street 2:CASTROP CENTER
Mailing Address - City:ATHENS
Mailing Address - State:OH
Mailing Address - Zip Code:45701
Mailing Address - Country:US
Mailing Address - Phone:740-566-4870
Mailing Address - Fax:740-566-4871
Practice Address - Street 1:75 HOSPITAL DRIVE SUITE 200
Practice Address - Street 2:CASTROP CENTER
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701
Practice Address - Country:US
Practice Address - Phone:740-566-4870
Practice Address - Fax:740-566-4871
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-29
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes EducatorGroup - Multi-Specialty
No133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHOH9311252Medicare ID - Type Unspecified