NPIMap

Organization Active NPI

Emergency Professional Services, Inc.

Doing business as Emergency Professional Services of Ohio, Inc.

  • Emergency Medicine Physician
  • Seaman, OH
National Provider Identifier
1093762353
Registry record updated Aug 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
EMERGENCY PROFESSIONAL SERVICES, INC.
Doing business as
Emergency Professional Services of Ohio, Inc.
Practice address
230 Medical Center Dr
Seaman, OH 45679-8002
Phone
(937) 386-3400
NPI assigned
May 30, 2006
Last updated
Aug 15, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2017

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

Authorized official

Name
Dr. Laura L Dollison, D.O.
Title
President
Phone
(440) 842-7990

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X NU Primary
Physician Assistant 363A00000X NU
Medical Physician Assistant 363AM0700X NU
Nurse Practitioner 363L00000X NU
Family Nurse Practitioner 363LF0000X NU

Addresses

Primary practice location

230 Medical Center Dr
Seaman, OH 45679-8002

Mailing address

307 S Evergreen Ave
Woodbury, NJ 08096-2739
Phone (856) 686-4316

Other identifiers 1

IdentifierTypeStateIssuer
CA8447OtherOHMEDICARE TRAVELERS RRGA

Other names 1

  • Emergency Professional Services of Ohio, Inc. Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040511000864 OH Part B Supplier - Clinic/Group Practice 7214832435 Receives reassigned benefits from 1,060 practitioners
Practice locations: Middleberg HTS, OH; Norwalk, OH; Port Clinton, OH; Salem, OH; Chillicothe, OH; Seaman, OH; Tiffin, OH; Upper Sandusky, OH…
O20161229001007 KY Part B Supplier - Clinic/Group Practice 7214832435 Receives reassigned benefits from 23 practitioners
Practice locations: Ashland, KY

National Provider Directory

National Provider Directory

Locations

2620 Ridgewood Rd
#8447
Akron, OH 44313

2351 E 22nd St
Cleveland, OH 44115
Phone (216) 363-2536

Practitioners & affiliated clinicians

Practitioners 1,092

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 1,092

NPI Registry JSON

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1502755200000",
    "number": "1093762353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 S EVERGREEN AVE",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080962739",
            "telephone_number": "856-686-4316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 MEDICAL CENTER DR",
            "city": "SEAMAN",
            "state": "OH",
            "postal_code": "456798002",
            "telephone_number": "937-386-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERGENCY PROFESSIONAL SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-30",
        "last_updated": "2017-08-15",
        "status": "A",
        "authorized_official_last_name": "DOLLISON",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "440-842-7990",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE TRAVELERS RRGA",
            "identifier": "CA8447",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Emergency Professional Services of Ohio, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Seaman, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2017; 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.