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Individual provider Active NPI

Charles P House Sr., DO

  • Family Medicine Physician
  • Clyde, OH
National Provider Identifier
1225007016
Registry record updated Nov 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34-007179 Issued in OH
Practice address
420 W McPherson Hwy
Clyde, OH 43410-1133
Phone
(419) 547-0584
Fax
(419) 547-8918
NPI assigned
Mar 15, 2006
Last updated
Nov 23, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 34-007179 OH Primary

Addresses

Primary practice location

420 W McPherson Hwy
Clyde, OH 43410-1133

Mailing address

PO Box 179
Bellevue, OH 44811-0179
Phone (440) 274-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041130000051 OH Practitioner - General PracticePractitioner - Family Practice 9436114782 Reassigns benefits to 1 organization
Practice locations: Clyde, OH

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
University of New England, College of Osteo Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Magruder Medical Group LTDGroup PAC ID 1951675198, 13 clinicians

Practice addresses (Care Compare)

615 Fulton St
Suite 200
Port Clinton, OH 43452-2001
Phone (419) 734-4539

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
76.49 of 100Reported as group
Quality
55.95
Promoting interoperability
89
Improvement activities
40
Cost
74.86

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
34-007179OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Magruder Medical Group LTD Family Medicine CurrentSince May 11, 2024 Accepting new patients
MCR Health, Inc. Family Medicine Past Accepting new patients
Wakeman Area Family Care Center Family Medicine Past Accepting new patients
Charles P House Sr DO Family Medicine PastSince Jan 1, 1990 Accepting new patients
Charles P House Sr. D.O. Inc Family Medicine PastSince Jan 1, 1990 Accepting new patients
Sebring Hospital Management Associates LLC Past Accepting new patients

Locations

2861 East Harbor Rd
Port Clinton, OH 43452
Phone (419) 732-1833

611 Fulton St
Ste C
Port Clinton, OH 43452
Phone (419) 732-6500

615 Fulton St
Port Clinton, OH 43452
Phone (419) 734-3131

615 Fulton St
Ste 200
Port Clinton, OH 43452
Phone (419) 725-6850

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258934400000",
    "number": "1225007016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 179",
            "city": "BELLEVUE",
            "state": "OH",
            "postal_code": "448110179",
            "telephone_number": "440-274-5000",
            "fax_number": "440-716-8608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 W MCPHERSON HWY",
            "city": "CLYDE",
            "state": "OH",
            "postal_code": "434101133",
            "telephone_number": "419-547-0584",
            "fax_number": "419-547-8918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUSE",
        "first_name": "CHARLES",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-15",
        "last_updated": "2009-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34-007179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clyde, OH

Sources for this page

Verify at the official NPI Registry.