MEDICARE: AMERICAN HEALTH NETWORK OF OHIO, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207R00000X	Internal Medicine Physician
2	363AM0700X	Medical Physician Assistant
3	363LF0000X	Family Nurse Practitioner
4	363LA2200X	Adult Health Nurse Practitioner
5	207Q00000X	Family Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386675544
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMERICAN HEALTH NETWORK OF OHIO, LLC

Provider Business Mailing Address
First Line	:	680 BUCKLES CT N STE 1A
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43230-6928
Country	:	US
Telephone Number	:	614-986-0125
Fax Number	:	614-237-1646

Provider Business Practice Location Address
First Line	:	680 BUCKLES CT N STE 1A
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43230-6928
Country	:	US
Telephone Number	:	614-986-0125
Fax Number	:	614-237-1646

Authorized Official
Title or Position	:	VP OPERATIONS OHIO
Name	:	MR. BRAD A COURTER
Credential	:
Telephone Number	:	614-794-5053

Provider Enumeration Date	:	07/06/2006
Last Update Date	:	01/29/2026

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Directions to “AMERICAN HEALTH NETWORK OF OHIO, LLC ” Practice Location

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