Individual provider Active NPI

Jerome D. Homish, D.O.

  • Family Medicine Physician
  • Lithonia, GA
National Provider Identifier
1316991870
Registry record updated May 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
89940 Issued in GA
Practice address
7231 Rockbridge Rd
Lithonia, GA 30058-5918
Phone
(678) 710-9270
Fax
(470) 365-2880
NPI assigned
May 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 34-005148 OH
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X 89940 GA
Family Medicine Physician 207Q00000X 89940 GA Primary

Addresses

Primary practice location

7231 Rockbridge Rd
Lithonia, GA 30058-5918

Mailing address

7231 Rockbridge Rd
Lithonia, GA 30058-5918
Phone (678) 710-9270

Other identifiers 7

IdentifierTypeStateIssuer
1316991870OtherNPI
CE0006OtherRR MEDICARE
000000185128OtherOHUNISON MEDICAID
001714142OtherMOUNTAIN STATE BC/BS
0834271OtherOHMOLINA MEDICAID
000000251326OtherANTHEM BC/BS
2003178000MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
34-005148OHMDFamily Medicine Physician
12625GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Athens Medical Associates, LLC Family Medicine Past Accepting new patients
Athens Medical Associates, LLC Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652140800000",
    "number": "1316991870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7231 ROCKBRIDGE RD",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300585918",
            "telephone_number": "678-710-9270",
            "fax_number": "478-365-2880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7231 ROCKBRIDGE RD",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300585918",
            "telephone_number": "678-710-9270",
            "fax_number": "470-365-2880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOMISH",
        "first_name": "JEROME",
        "middle_name": "D.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2022-05-10",
        "certification_date": "2022-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34-005148",
            "primary": false
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "GA",
            "license": "89940",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "89940",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1316991870",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CE0006",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON MEDICAID",
            "identifier": "000000185128",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOUNTAIN STATE BC/BS",
            "identifier": "001714142",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOLINA MEDICAID",
            "identifier": "0834271",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "000000251326",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2003178000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lithonia, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2022; 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.