The Ohio Masonic Home

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

THE OHIO MASONIC HOME

Practice address

2655 West National Road
Springfield, OH 45504-3617

Phone

(937) 525-3067

Fax

(937) 525-3067

NPI assigned

Jul 30, 2019

Organization subpart

No

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

Authorized official

Name

Anthony Berardi

Title

President

Phone

(937) 525-3015

Specialties & licenses 1

Addresses

Other names 1

• Springfield Masonic Community Doing business as

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

CLIA laboratory certificates

Tax ID family

Springfield Masonic Community3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Springfield Masonic Community

  • Clinical Medical Laboratory
  • Springfield, OH
  • NPI 1710211149
  NPD tax ID
• The Ohio Masonic Home

  • Skilled Nursing Facility
  • Springfield, OH
  • NPI 1962510305
  NPD tax ID

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

{
    "created_epoch": "1564444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564444800000",
    "number": "1508410465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2655 WEST NATIONAL ROAD",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455043617",
            "telephone_number": "937-525-3067",
            "fax_number": "937-525-3067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2655 WEST NATIONAL ROAD",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455043617",
            "telephone_number": "937-525-3067",
            "fax_number": "937-525-3067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE OHIO MASONIC HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-30",
        "last_updated": "2019-07-30",
        "status": "A",
        "authorized_official_last_name": "BERARDI",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "937-525-3015"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Springfield Masonic Community",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Desiree A Tharp, LPC
• The Ability Builders
• The Community Hospital Mammography Center
• The Community Hospital of Springfield and Clark County
• The Community Hospital Snu
• The Ohio Masonic Home
• Theracare Inc
• Rebecca L Thiede, LABOR DOULA
• Raymond Thiel
• Thomas E Dunaway MD LLC

• Internal Medicine Physician in Springfield, OH
• Providers in Springfield, OH by specialty
• Internal Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2019; 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.