NPIMap

Healogics Specialty Physicians of Ohio, LLC

Organization Active NPI Undersea and Hyperbaric Medicine (Preventive Medicine) Physician · Troy, OH

NPI 1124430491 · NPPES record last updated Jun 1, 2023

Key facts

NPI
1124430491
Entity type
Organization (NPI type 2)
Primary specialty
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician 2083P0011X
Legal business name
HEALOGICS SPECIALTY PHYSICIANS OF OHIO, LLC
Practice address
3130 N County Road 25a
Troy, OH 45373-1337
Phone
(937) 440-7888
Fax
(937) 440-7880
NPI assigned
May 21, 2014
Organization subpart
No

Authorized official

Name
Frank Williams
Title
Ceo
Phone
(904) 446-3519

Practitioners 26

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

View all 26

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OH

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20150226002009 OH Part B Supplier - Clinic/Group Practice 1759607229 Receives reassigned benefits from 23 practitioners
Practice locations: Westerville, OH; Hamilton, OH; Liberty Township, OH; Middletown, OH; Oxford, OH; Zanesville, OH; Troy, OH; Grove City, OH…

National Provider Directory

Locations

5300 N Meadows Dr
Ste 130
Grove City, OH 43123

7117 Dutchland Pkwy
Liberty Township, OH 45044
Phone (513) 770-2797

200 Medical Center Dr
Fl 1
Middletown, OH 45005
Phone (513) 420-5700

200 Medical Center Dr
Bldg First
Middletown, OH 45005
Phone (513) 974-5700

4953 Section Ave
Norwood, OH 45212
Phone (513) 712-9200

3130 N County Road 25A
Ste 101
Troy, OH 45373
Phone (615) 320-4218

3130 N County Road 25A
Ste 1
Troy, OH 45373

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207P00000X
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207Q00000X
Internal Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207R00000X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 2083P0011X Yes
Surgery Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 208600000X
Physician Assistant
Group: 193200000X MULTI-SPECIALTY GROUP		 363A00000X
Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP		 363L00000X

Addresses

Primary practice location

3130 N County Road 25a
Troy, OH 45373-1337

Mailing address

5220 Belfort Rd Ste 130
Jacksonville, FL 32256-6018
Phone (904) 446-3451

Other identifiers

IdentifierTypeStateIssuer
0152904MedicaidOH

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 1, 2023.

{
    "created_epoch": "1400630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685577600000",
    "number": "1124430491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5220 BELFORT RD STE 130",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566018",
            "telephone_number": "904-446-3451",
            "fax_number": "904-446-3032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 N COUNTY ROAD 25A",
            "city": "TROY",
            "state": "OH",
            "postal_code": "453731337",
            "telephone_number": "937-440-7888",
            "fax_number": "937-440-7880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALOGICS SPECIALTY PHYSICIANS OF OHIO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-21",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "FRANK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "904-446-3519"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2083P0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0152904",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, OH

All providers in Troy, OH · Undersea and Hyperbaric Medicine (Preventive Medicine) Physician in Ohio

Sources for this page

Verify at the official NPI Registry.