NPIMap

Organization Active NPI

Health Professionals of Holmes County, Inc

Doing business as Pomerene Medical Group

  • Primary Care Clinic/Center
  • Millersburg, OH
National Provider Identifier
1083897987
Registry record updated Jan 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
HEALTH PROFESSIONALS OF HOLMES COUNTY, INC
Doing business as
Pomerene Medical Group
Practice address
1261 Wooster Rd
Suite 200
Millersburg, OH 44654-1568
Phone
(330) 674-2822
Fax
(330) 763-2063
NPI assigned
Dec 13, 2007
Last updated
Jan 2, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
HEALTH PROFESSIONALS OF HOLMES COUNTY, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 2, 2024

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

Authorized official

Name
Mr. Jason Justus
Title
Chief Financial Officer
Phone
(330) 674-1015

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X NU Primary
Specialist 174400000X NU

Addresses

Primary practice location

1261 Wooster Rd
Suite 200
Millersburg, OH 44654-1568

Mailing address

981 Wooster Rd
Millersburg, OH 44654-1536
Phone (330) 674-1584

Other identifiers 1

IdentifierTypeStateIssuer
2806477MedicaidOH

Other names 1

  • Pomerene Medical Group Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070702000432 OH Part B Supplier - Clinic/Group Practice 6002916194 Receives reassigned benefits from 94 practitioners
15 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Berlin, OH; Sugarcreek, OH; Millersburg, OH; Loudonville, OH; Dover, OH

Other NPIs on the same Medicare enrollment 15

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

View all 15

National Provider Directory

National Provider Directory
Part of
HPHC Cardiac Rehab

Practitioners & affiliated clinicians

Practitioners 35

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 35

NPI Registry JSON

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

{
    "created_epoch": "1197504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704153600000",
    "number": "1083897987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "981 WOOSTER RD",
            "city": "MILLERSBURG",
            "state": "OH",
            "postal_code": "446541536",
            "telephone_number": "330-674-1584",
            "fax_number": "330-674-9314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1261 WOOSTER RD",
            "address_2": "SUITE 200",
            "city": "MILLERSBURG",
            "state": "OH",
            "postal_code": "446541568",
            "telephone_number": "330-674-2822",
            "fax_number": "330-763-2063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH PROFESSIONALS OF HOLMES COUNTY, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HEALTH PROFESSIONALS OF HOLMES COUNTY, INC",
        "enumeration_date": "2007-12-13",
        "last_updated": "2024-01-02",
        "certification_date": "2023-12-28",
        "status": "A",
        "authorized_official_last_name": "JUSTUS",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "330-674-1015",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2806477",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pomerene Medical Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pomerene Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Millersburg, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.