NPIMap

Organization Active NPI

Health Professionals of Holmes County, Inc

Doing business as Pomerene Family Care

  • Specialist
  • Sugarcreek, OH
National Provider Identifier
1407188469
Registry record updated Aug 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
HEALTH PROFESSIONALS OF HOLMES COUNTY, INC
Doing business as
Pomerene Family Care
Practice address
126 S Broadway St
Sugarcreek, OH 44681-9378
Phone
(330) 852-2504
Fax
(330) 763-2063
NPI assigned
Feb 2, 2010
Last updated
Aug 7, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
HEALTH PROFESSIONALS OF HOLMES COUNTY, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 7, 2012

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

Authorized official

Name
Mr. Jason Justus
Title
Chief Financial Officer
Phone
(330) 674-1015

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary

Addresses

Primary practice location

126 S Broadway St
Sugarcreek, OH 44681-9378

Mailing address

1261 Wooster Rd
Suite 200
Millersburg, OH 44654-1568
Phone (330) 674-3333

Other identifiers 1

IdentifierTypeStateIssuer
2811498MedicaidOH

Other names 1

  • Pomerene Family Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070702000432 OH Part B Supplier - Clinic/Group Practice 6002916194 Receives reassigned benefits from 94 practitioners
15 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Berlin, OH; Sugarcreek, OH; Millersburg, OH; Loudonville, OH; Dover, OH

Other NPIs on the same Medicare enrollment 15

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 15

National Provider Directory

National Provider Directory
Part of
HPHC Cardiac Rehab

NPI Registry JSON

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

{
    "created_epoch": "1265068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344297600000",
    "number": "1407188469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1261 WOOSTER RD",
            "address_2": "SUITE 200",
            "city": "MILLERSBURG",
            "state": "OH",
            "postal_code": "446541568",
            "telephone_number": "330-674-3333",
            "fax_number": "330-763-2063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 S BROADWAY ST",
            "city": "SUGARCREEK",
            "state": "OH",
            "postal_code": "446819378",
            "telephone_number": "330-852-2504",
            "fax_number": "330-763-2063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH PROFESSIONALS OF HOLMES COUNTY, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HEALTH PROFESSIONALS OF HOLMES COUNTY, INC",
        "enumeration_date": "2010-02-02",
        "last_updated": "2012-08-07",
        "status": "A",
        "authorized_official_last_name": "JUSTUS",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "330-674-1015",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2811498",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pomerene Family Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sugarcreek, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.