Organization Active NPI

Medical Home Primary Care Center

  • Family Medicine Physician
  • Zanesville, OH
National Provider Identifier
1578870911
Registry record updated Sep 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35075041D Issued in 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
Last updated
Sep 7, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2010

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

Authorized official

Name
Cheryl L Crowder
Title
Administrative Director
Phone
(740) 455-3304

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 35075041D OH Primary

Addresses

Primary practice location

3620 Court Dr
Zanesville, OH 43701-6456

Mailing address

PO Box 1821
Zanesville, OH 43702-1821
Phone (740) 455-3304

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101118000924 OH Part B Supplier - Clinic/Group Practice 8729274501 Receives reassigned benefits from 6 practitioners
Practice locations: Zanesville, OH

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
36D2013908Medical Home Primary Care Center3620 Court Drive, Zanesville, OH 43701Provider-performed microscopySep 26, 2026

National Provider Directory

National Provider Directory

Locations

3620 Court Dr
Zanesville, OH 43701
Phone (740) 454-1248

3620 Court Dr
Ste K
Zanesville, OH 43701
Phone (740) 454-1248

Practitioners & affiliated clinicians

Practitioners 75

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 75

NPI Registry JSON

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

{
    "created_epoch": "1283817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283817600000",
    "number": "1578870911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1821",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "437021821",
            "telephone_number": "740-455-3304",
            "fax_number": "740-455-3686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3620 COURT DR",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "437016456",
            "telephone_number": "740-454-1248",
            "fax_number": "740-454-8183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL HOME PRIMARY CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-07",
        "last_updated": "2010-09-07",
        "status": "A",
        "authorized_official_last_name": "CROWDER",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ADMINISTRATIVE DIRECTOR",
        "authorized_official_telephone_number": "740-455-3304"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35075041D",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Sep 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.