MEDICARE: SURGEVITY, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency
2	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1184570236
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SURGEVITY, LLC

Provider Business Mailing Address
First Line	:	4820 DRAYTON RD
Second Line	:
City	:	HILLIARD
State	:	OH
Zip	:	43026-9725
Country	:	US
Telephone Number	:	614-202-7086
Fax Number	:

Provider Business Practice Location Address
First Line	:	4820 DRAYTON RD
Second Line	:
City	:	HILLIARD
State	:	OH
Zip	:	43026-9725
Country	:	US
Telephone Number	:	614-202-7086
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KAYONA WARD
Credential	:
Telephone Number	:	614-202-7086

Provider Enumeration Date	:	03/09/2026
Last Update Date	:	03/09/2026

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Directions to “SURGEVITY, LLC ” Practice Location

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