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FORM AND FUNCTION HEALTHCARE LLC
NPI 1932914389
Family Medicine in Columbus, OH

Active since February 12, 2025CLIA 36D2323706 · Waiver
4278 INDIANOLA AVE, COLUMBUS, OH 43214(419) 235-2823 Get Directions Write a Review

NPPES record last updated: March 10, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 10, 2025, Feb 17, 2025, Feb 12, 2025 (3 updates tracked since 2025).

About Form And Function Healthcare Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FORM AND FUNCTION HEALTHCARE LLC (NPI 1932914389) is a healthcare organization registered as a family medicine in Columbus, Ohio and active in the NPI registry since February 2025. The organization holds a CLIA Waiver certificate valid through May 11, 2027 and lists John P Bell, Vp Finance, as its authorized official.

NPPES Registry Identity

NPI1932914389
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameFORM AND FUNCTION HEALTHCARE LLC
Location Address4278 INDIANOLA AVEColumbus, OH 43214-2806
Mailing Address4278 Indianola AveColumbus, OH 43214-2806 · (419) 235-2823
Phone(419) 235-2823
Organization SubpartNo
Authorized OfficialJohn P BellVp Finance · (419) 235-2823
Enumeration DateFebruary 12, 2025
Last NPPES UpdateMarch 10, 20253 updates tracked since enumeration
NPPES CertifiedMarch 10, 2025
✔ NPI 1932914389 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedClinic/Center · Multi-SpecialtyTaxonomy 261QM1300X
4278 INDIANOLA AVE, Columbus, OH 43214
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 36D2323706

Form And Function Healthcare, LLC · Columbus, OH
Active · expires May 11, 2027
CLIA Number36D2323706
Laboratory TypePhysician Office
Certificate Effective DateMay 12, 2025
Certificate Expiration DateMay 11, 2027
Laboratory DirectorJennifer A. Bell
Laboratory Phone(614) 318-4144
Laboratory LocationForm And Function Healthcare, LLC4278 Indianola Avenue, Columbus, OH 43214
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. JENNIFER ANN BELL APRN-CNP
Nurse Practitioner (Primary Care)
4278 INDIANOLA AVE
COLUMBUS, OH 43214
Franklin County (614) 318-4144
MELVIN W THOMAS MD
Family Medicine
4278 INDIANOLA AVE
COLUMBUS, OH 43214
Franklin County (614) 262-0477

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Form And Function Healthcare LLC's NPI number?

The NPI number for Form And Function Healthcare LLC is 1932914389. It was assigned to this organization in the NPPES registry on February 12, 2025.

Where is Form And Function Healthcare LLC located?

Form And Function Healthcare LLC is located at 4278 Indianola Ave, Columbus, OH 43214. The listed phone number is (419) 235-2823.

What is Form And Function Healthcare LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Form And Function Healthcare LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 36D2323706) is associated with this NPI, valid through May 11, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Form And Function Healthcare LLC was last updated on March 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.