NPIMap

Organization Active NPI

Primary Medical Specialists, Inc

  • Internal Medicine Physician
  • Portsmouth, OH
National Provider Identifier
1356530018
Registry record updated Jul 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35043902 Issued in OH
Legal business name
PRIMARY MEDICAL SPECIALISTS, INC
Practice address
1611 27TH St
Fulton BLDG. Suite 101
Portsmouth, OH 45662-6931
Phone
(740) 353-4143
Fax
(740) 353-1714
NPI assigned
Oct 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2010

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

Authorized official

Name
Dr. Suzann M Bonzo, MD
Title
President
Phone
(740) 353-4143

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 35043902 OH Primary

Addresses

Primary practice location

1611 27TH St
Fulton BLDG. Suite 101
Portsmouth, OH 45662-6931

Mailing address

1611 27TH St
Fulton BLDG. Suite 101
Portsmouth, OH 45662-6931
Phone (740) 353-4143

Other identifiers 3

IdentifierTypeStateIssuer
000000262223OtherOHBLUECROSS/BLUE SHIELD
110248769OtherOHRR MEDICARE
2228619MedicaidOH

National Provider Directory

National Provider Directory

Locations

1611 27th St
Ste 101
Portsmouth, OH 45662
Phone (740) 353-4143

NPI Registry JSON

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

{
    "created_epoch": "1192665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277942400000",
    "number": "1356530018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 27TH ST",
            "address_2": "FULTON BLDG. SUITE 101",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456626931",
            "telephone_number": "740-353-4143",
            "fax_number": "740-353-1714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 27TH ST",
            "address_2": "FULTON BLDG. SUITE 101",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456626931",
            "telephone_number": "740-353-4143",
            "fax_number": "740-353-1714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY MEDICAL SPECIALISTS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-18",
        "last_updated": "2010-07-01",
        "status": "A",
        "authorized_official_last_name": "BONZO",
        "authorized_official_first_name": "SUZANN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "740-353-4143",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35043902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS/BLUE SHIELD",
            "identifier": "000000262223",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "110248769",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2228619",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2010; 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.