Organization Active NPI

Perry County Family Practice, Inc.

  • Rural Health Clinic/Center
  • New Lexington, OH
National Provider Identifier
1174792014
Registry record updated Sep 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
35-042516 Issued in OH
Legal business name
PERRY COUNTY FAMILY PRACTICE, INC.
Practice address
1625 Airport Rd
New Lexington, OH 43764-9749
Phone
(740) 342-5158
Fax
(740) 342-7393
NPI assigned
Feb 25, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2025

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

Authorized official

Name
Amjad RassNPI 1184797367
Title
Owner
Phone
(740) 680-6666

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 35-042516 OH Primary

Addresses

Primary practice location

1625 Airport Rd
New Lexington, OH 43764-9749

Mailing address

PO Box 596
New Lexington, OH 43764-0596
Phone (740) 342-5158

Other identifiers 2

IdentifierTypeStateIssuer
363829OtherOHRURAL HEALTH MEDICARE
0940996OtherOHRURAL HEALTH MEDICAID

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041015000905 OH Part A Provider - Rural Health Clinic 3173505138 Practice locations: New Lexington, OH

Rural health clinic certification: CCN 363829

Legal name
PERRY COUNTY FAMILY PRACTICE INC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Sep 2, 1993
Last certification
May 10, 2018
Ownership / control type
1B
Organization structure
CorporationProprietary
Incorporated
Jan 1, 1987 in OH
Enrollment address
1625 Airport Rd
New Lexington, OH 43764-9749

National Provider Directory

National Provider Directory
Tax ID family
Perry County Family Practice2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Amjad Al Rass Individual 5% Or Greater Direct Ownership InterestOwner Sep 30, 2025 100%
Operational/Managerial ControlOwner Sep 30, 2025 100%
Kristina Boring Individual W-2 Managing EmployeeOffice Manager Sep 30, 2025 100%

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1203897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758758400000",
    "number": "1174792014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 596",
            "city": "NEW LEXINGTON",
            "state": "OH",
            "postal_code": "437640596",
            "telephone_number": "740-342-5158",
            "fax_number": "740-342-6702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 AIRPORT RD",
            "city": "NEW LEXINGTON",
            "state": "OH",
            "postal_code": "437649749",
            "telephone_number": "740-342-5158",
            "fax_number": "740-342-7393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERRY COUNTY FAMILY PRACTICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-25",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A",
        "authorized_official_last_name": "RASS",
        "authorized_official_first_name": "AMJAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "740-680-6666"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "OH",
            "license": "35-042516",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RURAL HEALTH MEDICARE",
            "identifier": "363829",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RURAL HEALTH MEDICAID",
            "identifier": "0940996",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Lexington, OH

Sources for this page

Verify at the official NPI Registry.