Medical Home Primary Care Center
Organization Active NPI Family Medicine Physician · Zanesville, OH
NPI 1578870911 · NPPES record last updated Sep 7, 2010
Key facts
- NPI
- 1578870911
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 35075041D (OH)
- Legal business name
- MEDICAL HOME PRIMARY CARE CENTER
- Practice address
- 3620 Court Dr
Zanesville, OH 43701-6456 - Phone
- (740) 454-1248
- Fax
- (740) 454-8183
- NPI assigned
- Sep 7, 2010
- Organization subpart
- No
Authorized official
- Name
- Cheryl L Crowder
- Title
- Administrative Director
- Phone
- (740) 455-3304
Practitioners 75
-
Michelle Lynne Devoll, AGACNP
-
Shelly L Dunmyer, M.D.
-
Tammy C Lawson, CNP
-
Janell M Potts, CNP
-
Kadi Lepi Addy, WHNP-BC
-
Tammy Ann Anderson, CNP
-
Sean B Barnes, M.D.
-
Tiffany Lynne Blaz, RN, MSN, FNP-C
-
Edward Lawrence Colby, D.O.
-
Earl Edwin Conaway Jr., M.D.
-
Larry Ira Cowan, D.O.
-
Molly Jo Davis, NP
-
Dylan E Eubanks, APRN
-
Lisa Flarey, DO
-
James Gasparine, M.D.
-
Mark T Goggin, M.D.
-
Patrick Goggin, M. D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 36D2013908 | Medical Home Primary Care Center | Provider-performed microscopy | Sep 26, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20101118000924 | OH | Part B Supplier - Clinic/Group Practice | 8729274501 |
Receives reassigned benefits from 6 practitioners Practice locations: Zanesville, OH |
National Provider Directory
Locations
3620 Court Dr
Ste K
Zanesville, OH 43701
Phone (740) 454-1248
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | 35075041D | OH | Yes |
Addresses
Primary practice location
3620 Court Dr
Zanesville, OH 43701-6456
Mailing address
PO Box 1821
Zanesville, OH 43702-1821
Phone (740) 455-3304
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2078648 | Medicaid | OH |
Other providers in Zanesville, OH
- McVey Consultants LTD.
- Sara Beth McVey
- Jody Lynn Mealey
- Med-Ox Home Medical
- Medical Associates of Zanesville
- Richard L Meilander
- Evan J Meiman
- Ann Elizabeth Melick
- Richard L Mellon
- Trudy Mercer
All providers in Zanesville, OH · Family Medicine Physician in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 7, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.