Organization Active NPI

Harold J. Bowersox, D.O., Inc

  • Adult Medicine Physician
  • Willoughby Hills, OH
National Provider Identifier
1174611453
Registry record updated Nov 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
Legal business name
HAROLD J. BOWERSOX, D.O., INC
Practice address
34950 Chardon Road
Suite 206
Willoughby Hills, OH 44094
Phone
(440) 602-7700
Fax
(440) 602-9540
NPI assigned
Oct 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2007

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

Authorized official

Name
Dr. Harold Jonathan Bowersox, D.O.
Title
Physician
Phone
(440) 602-7700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207QA0505X Primary

Addresses

Primary practice location

34950 Chardon Road
Suite 206
Willoughby Hills, OH 44094

Mailing address

34950 Chardon Rd
Suite 206
Willoughby, OH 44094-9162
Phone (440) 602-7700

Other identifiers 1

IdentifierTypeStateIssuer
2731422MedicaidOH

National Provider Directory

National Provider Directory

Locations

34950 Chardon Rd
Ste 206
Willoughby Hills, OH 44094
Phone (440) 571-0006

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196380800000",
    "number": "1174611453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34950 CHARDON RD",
            "address_2": "SUITE 206",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440949162",
            "telephone_number": "440-602-7700",
            "fax_number": "440-602-9540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34950 CHARDON ROAD",
            "address_2": "SUITE 206",
            "city": "WILLOUGHBY HILLS",
            "state": "OH",
            "postal_code": "44094",
            "telephone_number": "440-602-7700",
            "fax_number": "440-602-9540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAROLD J. BOWERSOX, D.O., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2007-11-30",
        "status": "A",
        "authorized_official_last_name": "BOWERSOX",
        "authorized_official_first_name": "HAROLD",
        "authorized_official_middle_name": "JONATHAN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "440-602-7700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2731422",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Willoughby Hills, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2007; 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.