Physician Management Services of Southeast Ohio, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PHYSICIAN MANAGEMENT SERVICES OF SOUTHEAST OHIO, LLC

Practice address

300 Business Pkwy
Carlisle, OH 45005-6331

Phone

(888) 829-8550

NPI assigned

Feb 6, 2019

Organization subpart

Yes

Parent organization

VAXCARE CORPORATIONAs reported in NPPES

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

Authorized official

Name

Brett Kenefick

Title

President

Phone

(888) 829-8550

Specialties & licenses 1

Addresses

Part of

Vaxcare Corporation

Locations

Practitioners 2

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

• James Dean Johns, MD

  • Family Medicine Physician
  • Canton, OH
  • NPI 1770589863
  NPD (past)
• Susan Parr McElroy-Marcus, MD

  • Internal Medicine Physician
  • Cincinnati, OH
  • NPI 1578657797
  NPD (past)

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

{
    "created_epoch": "1549411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651017600000",
    "number": "1104381920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3113 LAWTON RD STE 250",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328033517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 BUSINESS PKWY",
            "city": "CARLISLE",
            "state": "OH",
            "postal_code": "450056331",
            "telephone_number": "888-829-8550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "624 Youngstown Poland Rd",
            "address_purpose": "LOCATION",
            "city": "Struthers",
            "state": "OH",
            "postal_code": "444711106",
            "country_code": "US",
            "telephone_number": "888-829-8550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PHYSICIAN MANAGEMENT SERVICES OF SOUTHEAST OHIO, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VAXCARE CORPORATION",
        "enumeration_date": "2019-02-06",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-26",
        "status": "A",
        "authorized_official_last_name": "KENEFICK",
        "authorized_official_first_name": "BRETT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "888-829-8550"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bailey Jo Morgerson, RN
• Rebecca Suzanne Oconnell, RN
• Eunice Onuoha
• Pamela C Kline
• Heather Lynn Pesante Bass, LPN
• Don Pringle
• Amanda R Salyer, LPN
• Jacki Lynn Shackelford, RN
• Society for Handicapped Citizens Inc.
• Robert Dale Spencer Jr., LPN

• Family Medicine Physician in Carlisle, OH
• Providers in Carlisle, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.