Individual provider Active NPI

Joshua Timothy Stephen Clore, D.O.

  • Emergency Medicine Physician
  • Marietta, OH
National Provider Identifier
1396009304
Registry record updated Feb 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
34011285 Issued in OH
Practice address
401 Matthew St
Marietta, OH 45750-1635
Phone
(740) 376-1939
NPI assigned
Jun 25, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 58.004380 OH
Emergency Medicine Physician 207P00000X 34011285 OH Primary

Addresses

Primary practice location

401 Matthew St
Marietta, OH 45750-1635

Mailing address

PO Box 449
Marietta, OH 45750-0449

Other practice location 1

799 Farson St
Belpre, OH 45714-1082
Phone (740) 401-1150

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address emergency.providers@mmhs.medicity.net
Direct Messaging Address emergency.providers@mmhs.medicity.net

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140610000934 OH Practitioner - Emergency Medicine 0143444380 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marietta Memorial HospitalGroup PAC ID 8224928965, 387 clinicians

Practice addresses (Care Compare)

401 Matthew St
Marietta, OH 45750-1635
Phone (740) 374-1623

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34011285OHMDEmergency Medicine Physician
58.004380OHMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Marietta Memorial Hospital Emergency Medicine CurrentSince Jan 1, 2022 Accepting new patients
Mves Austintown LLC Emergency Medicine CurrentSince Oct 25, 2015 Accepting new patients
Marietta Memorial Hospital CurrentSince Jan 1, 2022 Accepting new patients
4M Emergency Systems Tod LLC Emergency Medicine CurrentSince May 1, 2014 Accepting new patients
Mercy Health Youngstown LLC PastSince May 1, 2014 Accepting new patients

Locations

799 Farson St
Belpre, OH 45714
Phone (740) 401-1150

401 Matthew St
Marietta, OH 45750
Phone (740) 374-1400

701 Hildreth Ln
Marietta, OH 45750
Phone (740) 371-7194

400 Matthew St
Ste 101
Marietta, OH 45750
Phone (740) 568-4150

667 Eastland Ave SE
Warren, OH 44484
Phone (330) 841-2378

1296 Tod Pl NW
Ste 200
Warren, OH 44485
Phone (330) 306-5040

6252 Mahoning Ave
Youngstown, OH 44515
Phone (330) 792-7418

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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": "1340582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644192000000",
    "number": "1396009304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 449",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "457500449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 MATTHEW ST",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "457501635",
            "telephone_number": "740-376-1939"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "799 Farson St",
            "address_purpose": "LOCATION",
            "city": "Belpre",
            "state": "OH",
            "postal_code": "457141082",
            "country_code": "US",
            "telephone_number": "740-401-1150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLORE",
        "first_name": "JOSHUA",
        "middle_name": "TIMOTHY STEPHEN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-25",
        "last_updated": "2022-02-07",
        "certification_date": "2022-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": "58.004380",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "34011285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "emergency.providers@mmhs.medicity.net",
            "affiliation": "N",
            "address_1": "799 Farson St",
            "city": "Belpre",
            "state": "OH",
            "country_code": "US",
            "postal_code": "457141082",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "emergency.providers@mmhs.medicity.net",
            "affiliation": "N",
            "address_1": "401 Matthew St",
            "city": "Marietta",
            "state": "OH",
            "country_code": "US",
            "postal_code": "457501635",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Marietta, OH

Sources for this page

Verify at the official NPI Registry.