Gary R. Huston D.O., Inc

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

34-00-4562 Issued in OH

Legal business name

GARY R. HUSTON D.O., INC

Practice address

177 West St
Conneaut, OH 44030-2153

Phone

(440) 593-6551

Fax

(440) 593-6522

NPI assigned

Feb 6, 2012

Last updated

Feb 6, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Gary Robert Huston, D.O,NPI 1104836881

Title

President

Phone

(440) 593-6551

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Locations

Practitioners 3

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.

• Gary Robert Huston, DO

  • Family Medicine Physician
  • Conneaut, OH
  • NPI 1104836881
  Medicare reassignment NPD Authorized official
• Joanne Hartmann Villegas, CNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Bedford, OH
  • NPI 1154752483
  NPD (past)
• Donna Lee Judkins Workman, CNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Conneaut, OH
  • NPI 1134206113
  NPD (past)

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

{
    "created_epoch": "1328486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328486400000",
    "number": "1114299104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 635",
            "address_2": "177 WEST ST",
            "city": "CONNEAUT",
            "state": "OH",
            "postal_code": "440300635",
            "telephone_number": "440-593-6551",
            "fax_number": "440-593-6522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 WEST ST",
            "city": "CONNEAUT",
            "state": "OH",
            "postal_code": "440302153",
            "telephone_number": "440-593-6551",
            "fax_number": "440-593-6522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY R. HUSTON D.O., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-06",
        "last_updated": "2012-02-06",
        "status": "A",
        "authorized_official_last_name": "HUSTON",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "440-593-6551",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.O,"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "OH",
            "license": "34-00-4562",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0772310",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nichole Jean Engelmann, RN
• Es3 Management Inc. (Lake Pointe Rehabilitation and Nursing Center)
• Trisha Mae Foltz, LPN
• Douglas K Franley, M.D.
• Lisa Marie Gagich, PHARMD
• Christine Gaskell
• Gerdes Pharmacy Inc
• Gerdes Pharmacy Inc
• Gerdes Pharmacy Inc
• Kerry W Gerdes, RPH

• General Practice Physician in Conneaut, OH
• Providers in Conneaut, OH by specialty
• General Practice Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2012; 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.