Provider Demographics
NPI:1366506453
Name:MERLIN, JESSICA
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:MERLIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 ACKERMAN RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-293-2957
Mailing Address - Fax:614-685-6533
Practice Address - Street 1:460 W 10TH AVE FL 5
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210-1240
Practice Address - Country:US
Practice Address - Phone:614-293-2957
Practice Address - Fax:614-685-6533
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.153799207RA0401X, 207RH0002X
AL30915207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051118206OtherBCBS
AL051118203OtherBCBS
AL051118209OtherBCBS
AL129711Medicaid
AL051119346OtherBCBS
AL129715Medicaid
AL129712Medicaid
AL129713Medicaid
AL129714Medicaid
AL129710Medicaid
AL129716Medicaid
AL051118208OtherBCBS
AL051118204OtherBCBS
AL051118205OtherBCBS
ALZ19099OtherVIVA
AL129709Medicaid
AL051118207OtherBCBS
MS06955818Medicaid
AL129712Medicaid
AL129715Medicaid