GRANT LESCALLETT
Complete NPI Record 1972197945
Physician Assistant in Columbus, OH
Active since February 21, 2021PECOS Enrolled
Complete NPI Dataset
This page contains the complete raw NPPES record for Grant Lescallett (NPI 1972197945), an individual physician assistant provider in Columbus, OH. All 29 fields on file are listed with their current values and official NPPES definitions, exactly as recorded in the National Plan and Provider Enumeration System. Only fields that contain data are included, so the number of fields shown varies from one NPI record to another.
Use the tools below to filter fields by category, search within the record, or jump straight to a specific field. You can download the full record as a CSV, JSON, Markdown or text file, or filter first and export only the fields you need. The Print Clean Summary button produces a printer-friendly copy of the record.
Registry File Document Utilities
- NPI: 1972197945 Field 1/29
- The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
- Entity Type Code: 1 Field 2/29
- Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
- Provider Last Name Legal Name: LESCALLETT Field 3/29
- The last name of the provider. If the provider is an individual, this is the legal name.
- Provider First Name: GRANT Field 4/29
- The first name of the provider, if the provider is an individual.
- Provider First Line Business Mailing Address: 700 CHILDRENS DR Field 5/29
- The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
- Provider Business Mailing Address City Name: COLUMBUS Field 6/29
- The city name in the mailing address of the provider being identified.
- Provider Business Mailing Address State Name: OH Field 7/29
- The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
- Provider Business Mailing Address Postal Code: 432052664 Field 8/29
- The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
- Provider Business Mailing Address Country Code If outside U S : US Field 9/29
- The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
- Provider Business Mailing Address Telephone Number: 6147222000 Field 10/29
- The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
- Provider First Line Business Practice Location Address: 380 BUTTERFLY GARDENS DR Field 11/29
- The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
- Provider Business Practice Location Address City Name: COLUMBUS Field 12/29
- The city name in the location address of the provider being identified.
- Provider Business Practice Location Address State Name: OH Field 13/29
- The State code in the location of the provider being identified.
- Provider Business Practice Location Address Postal Code: 432157508 Field 14/29
- The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
- Provider Business Practice Location Address Country Code If outside U S : US Field 15/29
- The country code in the location address of the provider being identified.
- Provider Business Practice Location Address Telephone Number: 6147226200 Field 16/29
- The telephone number associated with the location address of the provider being identified.
- Provider Business Practice Location Address Fax Number: 6147224440 Field 17/29
- The fax number associated with the location address of the provider being identified.
- Provider Gender Code: M Field 20/29
- The code designating the provider's gender if the provider is a person.
- Healthcare Provider Taxonomy Code 1: 363A00000X Field 21/29
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number 1: 50.007598 Field 22/29
- The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
- Provider License Number State Code 1: OH Field 23/29
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 1: Y Field 24/29
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Other Provider Identifier 1: 0496033 Field 25/29
- An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
- Other Provider Identifier Type Code 1: 05 Field 26/29
- A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
- Other Provider Identifier State 1: OH Field 27/29
- The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
- Is Sole Proprietor: N Field 28/29
- Indicates whether the provider is registered as a sole proprietor. This is a single-character code: "Y" means the provider operates as a sole proprietor, and "N" means they do not.
Secondary Practice Locations 6
The first line of the secondary practice location address of the provider being identified. For providers with more than one physical location, this is a secondary practice location address. This address cannot include a Post Office box.
6435 E Broad St
Location 1/6Columbus, OH 43213-1507 · Phone (614) 722-6200
433 N Cleveland Ave
Location 2/6Westerville, OH 43082-8095 · Phone (614) 722-2000
55 Dillmont Dr
Location 3/6Columbus, OH 43235-6458 · Phone (614) 722-2000
700 Childrens Dr
Location 4/6Columbus, OH 43205-2664 · Phone (614) 722-2000
7901 Diley Rd
Location 5/6Canal Winchester, OH 43110-9612 · Phone (614) 722-2000
5665 Venture Dr
Location 6/6Dublin, OH 43017-2159 · Phone (614) 722-6200
Other Provider Identifiers 1
Legacy and payer-issued identifiers reported to the NPPES registry for this provider.
0496033 Medicaid
Identifier 1/1State: OH
Medicaid (State-specific): A provider identification number assigned by an individual state's Medicaid program, used for billing and enrollment within that state's Medicaid system.
Medicaid (State-specific): A provider identification number assigned by an individual state's Medicaid program, used for billing and enrollment within that state's Medicaid system.
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