NPIMap

Organization Active NPI

Genesis Medical Group LLC

  • General Practice Physician
  • Zanesville, OH
National Provider Identifier
1063663433
Registry record updated Mar 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
GENESIS MEDICAL GROUP LLC
Practice address
945 Bethesda Dr Ste 200
Zanesville, OH 43701-1880
Phone
(740) 450-6147
NPI assigned
Oct 3, 2008
Last updated
Mar 1, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2021

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

Authorized official

Name
Mr. Mike D Norman
Title
Cfo
Phone
(740) 454-4773

Specialties & licenses 13

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy Physician 207KA0200X
Pain Medicine (Anesthesiology) Physician 207LP2900X
Family Medicine Physician 207Q00000X
Internal Medicine Physician 207R00000X
Cardiovascular Disease Physician 207RC0000X
Interventional Cardiology Physician 207RI0011X
Infectious Disease Physician 207RI0200X
Neurological Surgery Physician 207T00000X
Otolaryngology Physician 207Y00000X
Pediatrics Physician 208000000X
General Practice Physician 208D00000X Primary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X
Pain Medicine Physician 208VP0000X

Addresses

Primary practice location

945 Bethesda Dr Ste 200
Zanesville, OH 43701-1880

Mailing address

945 Bethesda Dr
Suite 200
Zanesville, OH 43701-0801
Phone (740) 450-6147

Other identifiers 1

IdentifierTypeStateIssuer
2861809MedicaidOH

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090107000547 OH Part B Supplier - Clinic/Group Practice 7719040385 Receives reassigned benefits from 319 practitioners
1 other NPI on this enrollment
Practice locations: Zanesville, OH; Junction City, OH; Coshocton, OH; Crooksville, OH; Dresden, OH; Cambridge, OH; New Concord, OH; New Lexington, OH…
O20200618000910 OH DME Supplier - Physician - Podiatry 7719040385 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Zanesville, OH

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 2

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D1049149Genesis Medical Group945 Bethesda Dr Ste 330, Zanesville, OH 43701Provider-performed microscopyDec 26, 2027

National Provider Directory

National Provider Directory
Tax ID family
Genesis Rehab Services18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

Locations (25 of 49)

1452 Clark St
Cambridge, OH 43725
Phone (740) 421-9240

L 3486
Columbus, OH 43260

23599 Airport Rd
Coshocton, OH 43812

48439 Genesis Dr
Ste F
Coshocton, OH 43812
Phone (740) 722-9555

499 S 2nd St
Ste 420
Coshocton, OH 43812
Phone (740) 722-9568

506 E Main St
Ste A
Junction City, OH 43748
Phone (740) 450-6144

1 E Main St
New Concord, OH 43762
Phone (740) 826-7050

301 Mike Clouse Dr
#2A
Somerset, OH 43783
Phone (740) 836-0035

301 Mike Clouse Dr
Ste A
Somerset, OH 43783

1210 Ashland Ave
Zanesville, OH 43701
Phone (740) 452-1905

1215 Newark Rd
Zanesville, OH 43701
Phone (740) 452-7359

1246 Ashland Ave
Zanesville, OH 43701
Phone (740) 432-4099

1246 Ashland Ave
Ste 100
Zanesville, OH 43701

1246 Ashland Ave
Ste 103
Zanesville, OH 43701
Phone (740) 586-6690

1246 Ashland Ave
Ste 106
Zanesville, OH 43701

1246 Ashland Ave
Ste 205
Zanesville, OH 43701
Phone (740) 454-5271

1346 Ashland Ave
Zanesville, OH 43701

23 N Maysville Ave
Zanesville, OH 43701
Phone (740) 453-0693

2525 Maple Ave
Ste 1
Zanesville, OH 43701
Phone (740) 453-6554

2800 Maple Ave
Ste 110P
Zanesville, OH 43701
Phone (740) 454-4010

2904 Bell St
Zanesville, OH 43701
Phone (740) 586-6828

2904 Bell St
Ste A
Zanesville, OH 43701
Phone (740) 586-6828

2951 Maple Ave
Ste 230
Zanesville, OH 43701

716 Adair Ave
Zanesville, OH 43701
Phone (740) 454-5239

751 Forest Ave
Zanesville, OH 43701
Phone (740) 452-4053

Practitioners & affiliated clinicians

Practitioners 402

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 402

NPI Registry JSON

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

{
    "created_epoch": "1222992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614556800000",
    "number": "1063663433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "945 BETHESDA DR",
            "address_2": "SUITE 200",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "437010801",
            "telephone_number": "740-450-6147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "945 BETHESDA DR STE 200",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "437011880",
            "telephone_number": "740-450-6147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-03",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A",
        "authorized_official_last_name": "NORMAN",
        "authorized_official_first_name": "MIKE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "740-454-4773",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2861809",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Zanesville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.