NPIMap

Organization Active NPI

Healthsource of Ohio, Inc.

Doing business as HealthSource Batavia Family Practice

  • Federally Qualified Health Center (FQHC)
  • Batavia, OH
National Provider Identifier
1003862343
Registry record updated Sep 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
HEALTHSOURCE OF OHIO, INC.
Doing business as
HealthSource Batavia Family Practice
HealthSource: Batavia Family Practice
Practice address
2055 Hospital Drive
Suite 130
Batavia, OH 45103-1946
Phone
(513) 732-0870
Fax
(513) 732-0873
NPI assigned
May 26, 2006
Last updated
Sep 11, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Joseph W Prather II, MD
Title
Ceo
Phone
(513) 707-4041

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

2055 Hospital Drive
Suite 130
Batavia, OH 45103-1946

Mailing address

424 Wards Corner Rd Ste 200
Loveland, OH 45140-6966
Phone (513) 707-4041

Other identifiers 2

IdentifierTypeStateIssuer
0827216MedicaidOH
CH7473OtherOHRAILROAD MEDICARE

Other names 2

  • HealthSource Batavia Family Practice Doing business as
  • HealthSource: Batavia Family Practice Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070424000419 OH Part A Provider - Federally Qualified Health Center (FQHC) 2264328749 Practice locations: Batavia, OH
O20140521002611 OH Part B Supplier - Clinic/Group Practice 2264328749 Receives reassigned benefits from 78 practitioners
21 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hillsboro, OH; Lebanon, OH; Loveland, OH; Mount Orab, OH; New Richmond, OH; Seaman, OH; Washington Court House, OH; Williamsburg, OH…

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1003862343. Details of each certification follow.

Federally qualified health center certification: CCN 361820

Legal name
HEALTHSOURCE OF OHIO, INC.
Doing business as
HEALTHSOURCE BATAVIA FAMILY PRACTICE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 1, 1992
Last certification
Jan 1, 1992
Ownership / control type
For profit – partnership
Organization structure
OtherNon-profit
Incorporated
Jul 1, 1976 in OH
Enrollment address
2055 Hospital Dr 130
Batavia, OH 45103-1978

Other NPIs with the same Medicare PAC ID 24

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 24

Other NPIs on the same Medicare enrollment 20

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 20

National Provider Directory

National Provider Directory
Tax ID family
Gerald L Price45 organizations share this tax ID, including this one

Other organizations with this tax ID 44

Organizations that report the same tax identification number in the National Provider Directory.

View all 44

Locations

100 River Valley Blvd
New Richmond, OH 45157
Phone (513) 553-3114

Ownership & related parties

All disclosed owners & managing parties 11

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Gail Koford Individual Corporate DirectorBoard Member May 28, 2024
Healthsource of Ohio, Inc. Organization, Batavia, OH Operational/Managerial Control Oct 1, 1976 100%
Douglas McDonald Individual Corporate DirectorBoard Member Jan 25, 2021
Patrick Hayes Individual Corporate DirectorBoard Member Jan 30, 2025
Stephen Hood Individual Corporate DirectorBoard Member Mar 31, 2022
Joseph W Prather Individual Corporate OfficerCeo May 28, 2024
W-2 Managing EmployeeCeo May 28, 2024
Tiffany Mattingly Individual Corporate DirectorBoard Member Apr 28, 2022
Mark McAndrew Individual Corporate DirectorBoard Member May 25, 2017
Jina L Bohl Individual Corporate DirectorBoard Member Mar 28, 2019
Konstantinos Elefter Individual Corporate DirectorBoard Member Dec 10, 2020
Cynthia L. Wright Sellers Individual Corporate DirectorBoard Member Jun 29, 2017

Owners & managing parties with NPI records 24

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

View all 24

Practitioners & affiliated clinicians

Practitioners 76

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 76

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789084800000",
    "number": "1003862343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 WARDS CORNER RD STE 200",
            "city": "LOVELAND",
            "state": "OH",
            "postal_code": "451406966",
            "telephone_number": "513-707-4041",
            "fax_number": "513-576-1020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 HOSPITAL DRIVE",
            "address_2": "SUITE 130",
            "city": "BATAVIA",
            "state": "OH",
            "postal_code": "451031946",
            "telephone_number": "513-732-0870",
            "fax_number": "513-732-0873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHSOURCE OF OHIO, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2026-09-11",
        "certification_date": "2026-09-11",
        "status": "A",
        "authorized_official_last_name": "PRATHER II",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "513-707-4041",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0827216",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CH7473",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HealthSource Batavia Family Practice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "HealthSource: Batavia Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Batavia, OH

Sources for this page

Verify at the official NPI Registry.