Basic Information
| Provider Information | |||||||||
| NPI: | 1992798441 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TROUTEN | ||||||||
| FirstName: | JASMINE | ||||||||
| MiddleName: | T. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 700 ACKERMAN RD STE 2120 | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432021559 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6142938054 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2050 KENNY RD | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432213502 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6142938054 | ||||||||
| FaxNumber: | 6142934890 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/30/2005 | ||||||||
| LastUpdateDate: | 12/15/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/15/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 35063673 | OH | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0081411000 | 05 | WV | MEDICAID | 0109297 | 05 | OH | MEDICAID | 55035705701 | 01 | WV | WV COMPENSATION | OTHER | 18995A | 01 | HEALTH PLAN OF UPPER OH V | OTHER | 5503570579A51 | 01 | ANTHEM BCBS | OTHER | 001718161 | 01 | MOUNTAIN STATE BCBS | OTHER | 0595950 | 01 | UMWA | OTHER | 23382908500 | 01 | OH | OHIO BWC | OTHER |