NPIMap

Organization Active NPI

Hles of Ohio, Inc.

  • Emergency Medicine Physician
  • Wauseon, OH
National Provider Identifier
1679806301
Registry record updated Mar 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
HLES OF OHIO, INC.
Practice address
725 S Shoop Ave
Wauseon, OH 43567-1702
Phone
(800) 998-7578
NPI assigned
Sep 14, 2009
Last updated
Mar 30, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2018

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

Authorized official

Name
Jennifer Moore
Title
Cfo
Phone
(415) 435-4591

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X Primary

Addresses

Primary practice location

725 S Shoop Ave
Wauseon, OH 43567-1702

Mailing address

PO Box 936429
Atlanta, GA 31193-6429
Phone (800) 377-8721

Other identifiers 3

IdentifierTypeStateIssuer
1679806301MedicaidMI
DP8339OtherRR MEDICARE
2991786MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091020000137 OH Part B Supplier - Clinic/Group Practice 2961549209 Receives reassigned benefits from 137 practitioners
2 other NPIs on this enrollment
Practice locations: Coshocton, OH; East Liverpool, OH; Wauseon, OH

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 139

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 139

NPI Registry JSON

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

{
    "created_epoch": "1252886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522368000000",
    "number": "1679806301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936429",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311936429",
            "telephone_number": "800-377-8721",
            "fax_number": "304-697-1155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 S SHOOP AVE",
            "city": "WAUSEON",
            "state": "OH",
            "postal_code": "435671702",
            "telephone_number": "800-998-7578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HLES OF OHIO, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-14",
        "last_updated": "2018-03-30",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "415-435-4591"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1679806301",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "DP8339",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2991786",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauseon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2018; 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.

Verify at the official NPI Registry.