NPIMap

Organization Active NPI

Health Professionals of Holmes County, Inc

  • Rural Health Clinic/Center
  • Loudonville, OH
National Provider Identifier
1144827478
Registry record updated Oct 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
HEALTH PROFESSIONALS OF HOLMES COUNTY, INC
Practice address
121 W Main St
Loudonville, OH 44842-1247
Phone
(419) 994-0212
Fax
(330) 763-2063
NPI assigned
Oct 9, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2020

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

Authorized official

Name
Jason Justus
Title
Ceo
Phone
(330) 674-1584

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

121 W Main St
Loudonville, OH 44842-1247

Mailing address

981 Wooster Rd
Millersburg, OH 44654-1536
Phone (330) 674-1584

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201117002020 OH Part A Provider - Rural Health Clinic 6002916194 Practice locations: Loudonville, OH

Rural health clinic certification: CCN 363876

Legal name
HEALTH PROFESSIONALS OF HOLMES COUNTY, INC.
Doing business as
POMERENE FAMILY CARE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Feb 17, 2021
Last certification
Feb 17, 2021
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Jul 18, 2002 in OH
Enrollment address
121 W Main St
Loudonville, OH 44842-1247

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D2121398Pomerene Family Care - Loudonville121 W Main St, Loudonville, OH 44842Provider-performed microscopyNov 2, 2026

National Provider Directory

National Provider Directory
Tax ID family
Health Professionals of Holmes County Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

3169 State Route 39
Millersburg, OH 44654
Phone 33047366156

Ownership & related parties

All disclosed owners & managing parties 13

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Stephanie Boring Individual W-2 Managing EmployeeClinical Manager Nov 1, 2020
Operational/Managerial ControlClinical Manager Nov 1, 2020
David M Findley Individual Corporate DirectorBoard Member Mar 1, 2016
Melvin J Yoder Individual Corporate DirectorBoard Member Nov 1, 2020
Jane C Graven Individual Corporate DirectorBoard Member Nov 1, 2020
Tia Cernava Individual Corporate OfficerCfo Nov 1, 2020
Daniel L Mathie Individual Corporate DirectorBoard Member Mar 1, 2016
Craig Mullet Individual Corporate DirectorBoard Member Nov 1, 2020
Sheila Knapp Individual Corporate DirectorBoard Member Nov 1, 2020
Pomerene Hospital Organization, Millersburg, OH Corporation, Non-profit 5% Or Greater Direct Ownership Interest Nov 1, 2020 100%
Ernest H Hershberger Individual Corporate DirectorBoard Member Nov 1, 2020
Leroy Yoder Individual Corporate DirectorBoard Member Nov 1, 2020
John Troyer Individual Corporate DirectorBoard Member Nov 1, 2020
Jenna Nichole Frakowski Individual Corporate OfficerMedical Director Nov 1, 2020
W-2 Managing EmployeeMedical Director Nov 1, 2020

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 41

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

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1602201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602201600000",
    "number": "1144827478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "981 WOOSTER RD",
            "city": "MILLERSBURG",
            "state": "OH",
            "postal_code": "446541536",
            "telephone_number": "330-674-1584",
            "fax_number": "330-674-9314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 W MAIN ST",
            "city": "LOUDONVILLE",
            "state": "OH",
            "postal_code": "448421247",
            "telephone_number": "419-994-0212",
            "fax_number": "330-763-2063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH PROFESSIONALS OF HOLMES COUNTY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-09",
        "last_updated": "2020-10-09",
        "certification_date": "2020-10-09",
        "status": "A",
        "authorized_official_last_name": "JUSTUS",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "330-674-1584"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loudonville, OH

Sources for this page

Verify at the official NPI Registry.