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General NPI Number Information
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NPI Number | 1255796025
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Entity Type | Individual
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Provider Name | DONALD ROOT III NP-C
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Gender | Male
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Dates
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Enumeration Date | 12/22/2015
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Last Update Date | 02/23/2022
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Provider Practice Location Address
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Address Line | 300 POLARIS PKWY STE 1100
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City | WESTERVILLE
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State | OH
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Zip | 43082-7277
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Country | US
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Telephone | 614-533-3400
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Fax | 614-533-3425
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Provider Business Mailing Address
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Address Line | 300 POLARIS PKWY STE 1100
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City | WESTERVILLE
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State | OH
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Zip | 43082-7277
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Country | US
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Telephone | 614-533-3400
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN.CNP.18502
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | COA.18502-NP
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 363LX0106X
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Taxonomy Name | Occupational Health Nurse Practitioner
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License Number | APRN.CNP.18502
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License Number State | OH
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