Active NPI
Jay Lugibihl, D.O., Inc.
- Family Medicine Physician
- Hanoverton, OH
National Provider Identifier
1679744775
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 34. 003675
- Legal business name
- JAY LUGIBIHL, D.O., INC.
- Practice address
- 29627 State RT. 30
Hanoverton, OH 44423 - Phone
- (330) 223-1547
- Fax
- (330) 223-1911
- NPI assigned
- Mar 17, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Jay Richard Lugibihl, D.O.
- Title
- President/Provider
- Phone
- (330) 223-1547
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 34. 003675 | OH | Primary |
Addresses
Primary practice location
29627 State RT. 30
Hanoverton, OH 44423
Mailing address
PO Box 195
Hanoverton, OH 44423-0195
Phone (330) 223-1547
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0764481 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080410000614 | OH | Part B Supplier - Clinic/Group Practice | 9133206410 |
Receives reassigned benefits from 1 practitioner Practice locations: Hanoverton, OH |
National Provider Directory
National Provider DirectoryPractitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- Hanoverton, OH
- NPI 1295764280
Family Medicine, OH
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205712000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1205712000000",
"number": "1679744775",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 195",
"city": "HANOVERTON",
"state": "OH",
"postal_code": "444230195",
"telephone_number": "330-223-1547",
"fax_number": "330-223-1911"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29627 STATE RT. 30",
"city": "HANOVERTON",
"state": "OH",
"postal_code": "44423",
"telephone_number": "330-223-1547",
"fax_number": "330-223-1911"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JAY LUGIBIHL, D.O., INC.",
"organizational_subpart": "NO",
"enumeration_date": "2008-03-17",
"last_updated": "2008-03-17",
"status": "A",
"authorized_official_last_name": "LUGIBIHL",
"authorized_official_first_name": "JAY",
"authorized_official_middle_name": "RICHARD",
"authorized_official_title_or_position": "PRESIDENT/PROVIDER",
"authorized_official_telephone_number": "330-223-1547",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "D.O."
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "OH",
"license": "34. 003675",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0764481",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Hanoverton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.