Organization Active NPI

Primecare of Southeastern Ohio, Inc.

  • Family Medicine Physician
  • Zanesville, OH
National Provider Identifier
1417932294
Registry record updated Mar 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PRIMECARE OF SOUTHEASTERN OHIO, INC.
Practice address
751 Forest Ave Ste 402
Zanesville, OH 43701-2878
Phone
(740) 454-4651
Fax
(740) 454-4653
NPI assigned
Dec 14, 2005
Last updated
Mar 25, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2022

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

Authorized official

Name
Mr. Dave Lucey
Title
Coo
Phone
(740) 454-4651

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary
Internal Medicine Physician 207R00000X
Pulmonary Disease Physician 207RP1001X
Obstetrics & Gynecology Physician 207V00000X
Pediatrics Physician 208000000X
Physical Therapist 225100000X
Nurse Practitioner 363L00000X

Addresses

Primary practice location

751 Forest Ave Ste 402
Zanesville, OH 43701-2878

Mailing address

860 Bethesda Dr
Zanesville, OH 43701-1800
Phone (740) 454-4651

Other identifiers 2

IdentifierTypeStateIssuer
CA1586OtherMEDICARE RAILROAD
0989499MedicaidOH

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D0332850Primecare of Southeastern Ohio, Inc751 Forest Avenue, Suite 401, Zanesville, OH 43701Provider-performed microscopyFeb 5, 2027
36D1069607Primecare of Southeastern Ohio, Inc751 Forest Avenue, Suite 402, Zanesville, OH 43701Certificate of waiverDec 7, 2026
36D2324552Primecare of Southeastern Ohio, Inc751 Forest Avenue, Suite 400, Zanesville, OH 43701Certificate of waiverMay 26, 2027

National Provider Directory

National Provider Directory

Locations

42 E 3rd St
Frazeysburg, OH 43822
Phone (740) 828-1020

167 S Main St
Roseville, OH 43777
Phone (740) 697-7373

1210 Ashland Ave
Zanesville, OH 43701
Phone (740) 452-1905

1246 Ashland Ave
Ste 203
Zanesville, OH 43701
Phone (740) 454-6158

751 Forest Ave
Ste 401
Zanesville, OH 43701
Phone (740) 454-8502

860 Bethesda Dr
Zanesville, OH 43701
Phone (740) 452-1905

860 Bethesda Dr
Ste 2
Zanesville, OH 43701
Phone (740) 452-1905

860 Bethesda Dr
Ste 3
Zanesville, OH 43701
Phone (740) 452-3725

945 Bethesda Dr
Ste 130
Zanesville, OH 43701
Phone (614) 454-9779

950 Bethesda Dr
Ste 3
Zanesville, OH 43701
Phone (740) 454-0196

975 Bethesda Dr
Zanesville, OH 43701
Phone (740) 452-4539

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648166400000",
    "number": "1417932294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 BETHESDA DR",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "437011800",
            "telephone_number": "740-454-4651",
            "fax_number": "740-454-4653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 FOREST AVE STE 402",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "437012878",
            "telephone_number": "740-454-4651",
            "fax_number": "740-454-4653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMECARE OF SOUTHEASTERN OHIO, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-14",
        "last_updated": "2022-03-25",
        "certification_date": "2022-03-25",
        "status": "A",
        "authorized_official_last_name": "LUCEY",
        "authorized_official_first_name": "DAVE",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "740-454-4651",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CA1586",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0989499",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Zanesville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.