Active NPI
Sugarcreek Physician Services, LLC
- Internal Medicine Physician
- Mount Vernon, OH
National Provider Identifier
1053256990
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- SUGARCREEK PHYSICIAN SERVICES, LLC
- Practice address
- 1330 Coshocton Ave
Mount Vernon, OH 43050-1495 - Phone
- (740) 393-9000
- NPI assigned
- Apr 20, 2026
- Last updated
- Apr 20, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Lisha C Falk
- Title
- Vice President
- Phone
- (337) 609-1221
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | Primary | ||
| Hospitalist Physician | 208M00000X | |||
| Physician Assistant | 363A00000X | |||
| Nurse Practitioner | 363L00000X |
Addresses
Primary practice location
1330 Coshocton Ave
Mount Vernon, OH 43050-1495
Mailing address
200 Corporate Blvd
Lafayette, LA 70508-3870
Phone (800) 893-9698
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1776643200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1776643200000",
"number": "1053256990",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 CORPORATE BLVD",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "705083870",
"telephone_number": "800-893-9698"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1330 COSHOCTON AVE",
"city": "MOUNT VERNON",
"state": "OH",
"postal_code": "430501495",
"telephone_number": "740-393-9000"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SUGARCREEK PHYSICIAN SERVICES, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2026-04-20",
"last_updated": "2026-04-20",
"certification_date": "2026-04-20",
"status": "A",
"authorized_official_last_name": "FALK",
"authorized_official_first_name": "LISHA",
"authorized_official_middle_name": "C",
"authorized_official_title_or_position": "VICE PRESIDENT",
"authorized_official_telephone_number": "337-609-1221"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "208M00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Hospitalist",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Mount Vernon, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.