Active NPI
Jerome D. Homish, D.O.
- Family Medicine Physician
- Lithonia, GA
National Provider Identifier
1316991870
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 89940
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316991870 | Other | NPI | |
| CE0006 | Other | RR MEDICARE | |
| 000000185128 | Other | OH | UNISON MEDICAID |
| 001714142 | Other | MOUNTAIN STATE BC/BS | |
| 0834271 | Other | OH | MOLINA MEDICAID |
| 000000251326 | Other | ANTHEM BC/BS | |
| 2003178000 | Medicaid | WV |
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.
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34-005148 | OH | MD | Family Medicine Physician |
| 12625 | GA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Obstetrics & Gynecology Nurse Practitioner
- Athens, OH
- NPI 1467583203
-
- Family Medicine Physician
- Athens, OH
- NPI 1982714358
-
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
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.