Active NPI
Harold Jonathan Bowersox, D.O.
- Family Medicine Physician
- Mentor, OH
National Provider Identifier
1447362066
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 34-003486
- Practice address
- 9500 Mentor Ave
Suite 360
Mentor, OH 44060-8713 - Phone
- (440) 255-5508
- Fax
- (440) 357-4416
- NPI assigned
- Aug 31, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 34-003486 | OH | Primary |
Addresses
Primary practice location
9500 Mentor Ave
Suite 360
Mentor, OH 44060-8713
Mailing address
PO Box 714328
Columbus, OH 43271-4328
Phone (440) 354-1899
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000210429 | Other | OH | ANTHEM |
| 080180930 | Other | OH | RAILROAD MEDICARE |
| 0548447 | Medicaid | OH |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | harold.bowersox@lhpg.eclinicaldirectplus.com | Direct |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34-003486 | OH | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lake Hospital System Inc | Family Medicine | Current | Accepting new patients |
| Lake Hospital System, Inc | Family Medicine | Current | Accepting new patients |
| Lake Hospital System, Inc. | Current | Accepting new patients |
Locations
8655 Market St
Mentor, OH 44060
Phone (440) 255-6400
9500 Mentor Ave
Ste 360
Mentor, OH 44060
Phone (440) 255-5508
10780 Kinsman Rd
Newbury, OH 44065
Phone (440) 564-5656
Interoperability endpoints
- hbowersox37111@ehrdirect.uhhospitals.org
Organizations & group practices 3
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614297600000",
"number": "1447362066",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 714328",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432714328",
"telephone_number": "440-354-1899",
"fax_number": "440-354-1845"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9500 MENTOR AVE",
"address_2": "SUITE 360",
"city": "MENTOR",
"state": "OH",
"postal_code": "440608713",
"telephone_number": "440-255-5508",
"fax_number": "440-357-4416"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOWERSOX",
"first_name": "HAROLD",
"middle_name": "JONATHAN",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2021-02-26",
"certification_date": "2021-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OH",
"license": "34-003486",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000210429",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "080180930",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0548447",
"state": "OH"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "harold.bowersox@lhpg.eclinicaldirectplus.com",
"affiliation": "N",
"endpointDescription": "Baseline West Direct Email Address",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CCDA",
"address_1": "8655 Market Street",
"city": "Mentor",
"state": "OH",
"country_code": "US",
"postal_code": "44060",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Mentor, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.