Healthcare Provider Details

I. General information

NPI: 1386248722
Provider Name (Legal Business Name): ROCKY MACHARIA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/25/2020
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4320 CRICKET PL
COLUMBUS OH
43231-6160
US

IV. Provider business mailing address

4320 CRICKET PL
COLUMBUS OH
43231-6160
US

V. Phone/Fax

Practice location:
  • Phone: 614-446-8176
  • Fax:
Mailing address:
  • Phone: 614-446-8176
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberPMH04260026
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberAPRN.CNP.0042017
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: