NPIMap

Organization Active NPI

Samaritan Family Care, Inc

Doing business as Gem City Surgical Hernia Center

  • Surgery Physician
  • Englewood, OH
National Provider Identifier
1477932036
Registry record updated May 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
SAMARITAN FAMILY CARE, INC
Doing business as
Gem City Surgical Hernia Center
Practice address
9000 N Main St
Ste 233B
Englewood, OH 45415-1180
Phone
(937) 832-9310
Fax
(937) 832-8613
NPI assigned
May 28, 2015
Last updated
May 28, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2015

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

Authorized official

Name
Kenneth Prunier
Title
President / Ceo
Phone
(937) 499-8205

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X Primary

Addresses

Primary practice location

9000 N Main St
Ste 233B
Englewood, OH 45415-1180

Mailing address

9000 N Main St
Ste 233B
Englewood, OH 45415-1180
Phone (937) 832-9310

Other identifiers 1

IdentifierTypeStateIssuer
0081307MedicaidOH

Other names 1

  • Gem City Surgical Hernia Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Samaritan Family Care I2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

9000 N Main St
Ste 233B
Englewood, OH 45415
Phone (937) 832-9310

NPI Registry JSON

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

{
    "created_epoch": "1432771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432771200000",
    "number": "1477932036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 N MAIN ST",
            "address_2": "STE 233B",
            "city": "ENGLEWOOD",
            "state": "OH",
            "postal_code": "454151180",
            "telephone_number": "937-832-9310",
            "fax_number": "937-832-8613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 N MAIN ST",
            "address_2": "STE 233B",
            "city": "ENGLEWOOD",
            "state": "OH",
            "postal_code": "454151180",
            "telephone_number": "937-832-9310",
            "fax_number": "937-832-8613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMARITAN FAMILY CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-28",
        "last_updated": "2015-05-28",
        "status": "A",
        "authorized_official_last_name": "PRUNIER",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "PRESIDENT / CEO",
        "authorized_official_telephone_number": "937-499-8205"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0081307",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gem City Surgical Hernia Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Englewood, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2015; 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.