NPIMap

Organization Active NPI

Premise Health of Ohio Medical, P.a

  • Primary Care Clinic/Center
  • Marysville, OH
National Provider Identifier
1356645014
Registry record updated Aug 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
PREMISE HEALTH OF OHIO MEDICAL, P.A
Practice address
14210 Scottslawn Rd
Marysville, OH 43041-0001
Phone
(937) 578-5555
Fax
(937) 578-5870
NPI assigned
Jan 10, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2022

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

Authorized official

Name
Jon Leizman, MD
Title
Owner
Phone
(216) 479-9063

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

14210 Scottslawn Rd
Marysville, OH 43041-0001

Mailing address

14210 Scottslawn Rd
Marysville, OH 43041-0001
Phone (937) 578-5555

Other names 1

  • Scotts Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Premise Health of Ohio Medical PA45 organizations share this tax ID, including this one

Other organizations with this tax ID 44

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

View all 44

NPI Registry JSON

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

{
    "created_epoch": "1294617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660608000000",
    "number": "1356645014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14210 SCOTTSLAWN RD",
            "city": "MARYSVILLE",
            "state": "OH",
            "postal_code": "430410001",
            "telephone_number": "937-578-5555",
            "fax_number": "937-578-5870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14210 SCOTTSLAWN RD",
            "city": "MARYSVILLE",
            "state": "OH",
            "postal_code": "430410001",
            "telephone_number": "937-578-5555",
            "fax_number": "937-578-5870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMISE HEALTH OF OHIO MEDICAL, P.A",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-10",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A",
        "authorized_official_last_name": "LEIZMAN",
        "authorized_official_first_name": "JON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "216-479-9063",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Scotts",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Scotts",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marysville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 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.