NPIMap

Genesis Medical Group LLC

Organization Active NPI General Practice Physician · Zanesville, OH

NPI 1063663433 · NPPES record last updated Mar 1, 2021

Key facts

NPI
1063663433
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Physician 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
Organization subpart
No

Authorized official

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

Other NPIs on the same Medicare enrollment 2

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

Other NPIs with the same Medicare PAC ID 1

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

Corporate family (same tax ID) 17

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

Practitioners 405

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 405

Laboratory certificates & supplier records

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

CLIA laboratory certificates

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in OH

Medicare enrollment records

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

National Provider Directory

Tax ID family
Genesis Roseville Pharmacy (18 organizations share this tax ID)

Locations (25 of 46)

61353 Southgate Rd
Ste 5
Cambridge, OH 43725
Phone (740) 421-9240

61353 Southgate Rd
Ste 3
Cambridge, OH 43725
Phone (740) 450-3296

L 3486
Columbus, OH 43260

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

23599 Airport Rd
Coshocton, OH 43812

1523 Walnut St
Ste 1
Coshocton, OH 43812
Phone (740) 295-3368

48439 Genesis Dr
Ste F
Coshocton, OH 43812
Phone (740) 623-4481

420 Downtowner Plz
Coshocton, OH 43812
Phone (740) 623-2949

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

1 E Main St
Ste 200A
New Concord, OH 43762
Phone (740) 826-7050

301 Mike Clouse Dr
Ste A
Somerset, OH 43783

301 Mike Clouse Dr
Ste 2
Somerset, OH 43783
Phone (740) 836-0031

800 Forest Ave
Rm 60481
Zanesville, OH 43701
Phone (740) 454-5398

2525 Maple Ave
Zanesville, OH 43701
Phone (740) 450-2222

1346 Ashland Ave
Zanesville, OH 43701

945 Bethesda Dr
Ste 40
Zanesville, OH 43701

800 Forest Ave
Rm 6048
Zanesville, OH 43701

800 Forest Ave
Rm 6841
Zanesville, OH 43701

1246 Ashland Ave
Ste 100
Zanesville, OH 43701

751 Forest Ave
Ste 301
Zanesville, OH 43701
Phone (740) 454-0804

950 Bethesda Dr
Ste 1
Zanesville, OH 43701
Phone (740) 586-6828

945 Bethesda Dr
Ste 340
Zanesville, OH 43701
Phone (740) 455-4923

1246 Ashland Ave
Ste 106
Zanesville, OH 43701

2800 Maple Ave
Ste A
Zanesville, OH 43701
Phone (740) 454-4200

751 Forest Ave
Ste 102
Zanesville, OH 43701
Phone (740) 454-4966

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207KA0200X
Pain Medicine (Anesthesiology) Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207LP2900X
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207Q00000X
Internal Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207R00000X
Cardiovascular Disease Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207RC0000X
Interventional Cardiology Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207RI0011X
Infectious Disease Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207RI0200X
Neurological Surgery Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207T00000X
Otolaryngology Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207Y00000X
Pediatrics Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 208000000X
General Practice Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 208D00000X Yes
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 208G00000X
Pain Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 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

IdentifierTypeStateIssuer
2861809MedicaidOH

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 1, 2021.

{
    "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": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Allergy & Immunology, Allergy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY 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

All providers in Zanesville, OH · General Practice Physician in Ohio

Sources for this page

Verify at the official NPI Registry.