NPIMap

Organization Active NPI

Prime Health Medical Services

  • Pain Clinic/Center
  • Dayton, OH
National Provider Identifier
1124298443
Registry record updated Jan 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Clinic/CenterTaxonomy code 261QP3300X
License
350868963G Issued in OH
Legal business name
PRIME HEALTH MEDICAL SERVICES
Practice address
8120 Garnet Dr
Dayton, OH 45458-2141
Phone
(937) 291-2511
Fax
(937) 291-2523
NPI assigned
Mar 3, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2011

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

Authorized official

Name
Dr. Laila Gomaa, M.D.
Title
President
Phone
(937) 291-2511

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 1982 OH
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X 35-068963 OH
Pain Clinic/Center 261QP3300X 350868963G OH Primary

Addresses

Primary practice location

8120 Garnet Dr
Dayton, OH 45458-2141

Mailing address

8120 Garnet Dr
Dayton, OH 45458-2141
Phone (937) 291-2511

Other identifiers 1

IdentifierTypeStateIssuer
2032982MedicaidOH

National Provider Directory

National Provider Directory

Locations

8120 Garnet Dr
Dayton, OH 45458
Phone (937) 291-2511

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1204502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294617600000",
    "number": "1124298443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8120 GARNET DR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454582141",
            "telephone_number": "937-291-2511",
            "fax_number": "937-291-2523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8120 GARNET DR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454582141",
            "telephone_number": "937-291-2511",
            "fax_number": "937-291-2523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME HEALTH MEDICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-03",
        "last_updated": "2011-01-10",
        "status": "A",
        "authorized_official_last_name": "GOMAA",
        "authorized_official_first_name": "LAILA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "937-291-2511",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "1982",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "OH",
            "license": "35-068963",
            "primary": false
        },
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": "OH",
            "license": "350868963G",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2032982",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2011; 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.