NPIMap

Organization Active NPI

Health Professionals of Holmes County, Inc

Doing business as Pomerene Pediatrics

  • Pediatrics Physician
  • Millersburg, OH
National Provider Identifier
1700069606
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
HEALTH PROFESSIONALS OF HOLMES COUNTY, INC
Doing business as
Pomerene Pediatrics
Practice address
1261 Wooster Rd
Suite 200
Millersburg, OH 44654-1568
Phone
(330) 674-3333
Fax
(330) 674-4484
NPI assigned
Dec 13, 2007
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
HEALTH PROFESSIONALS OF HOLMES COUNTY, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mr. Jason Justus
Title
Chief Financial Officer
Phone
(330) 674-1015

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X OH Primary

Addresses

Primary practice location

1261 Wooster Rd
Suite 200
Millersburg, OH 44654-1568

Mailing address

1261 Wooster Rd
Suite 200
Millersburg, OH 44654-1568
Phone (330) 674-3333

Other identifiers 1

IdentifierTypeStateIssuer
2801427MedicaidOH

Other names 1

  • Pomerene Pediatrics Doing business as

National Provider Directory

National Provider Directory
Tax ID family
HPHC Cardiac Rehab7 organizations share this tax ID, including this one
Part of
HPHC Cardiac Rehab

Other organizations with this tax ID 6

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

NPI Registry JSON

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

{
    "created_epoch": "1197504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1700069606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1261 WOOSTER RD",
            "address_2": "SUITE 200",
            "city": "MILLERSBURG",
            "state": "OH",
            "postal_code": "446541568",
            "telephone_number": "330-674-3333",
            "fax_number": "330-763-2063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1261 WOOSTER RD",
            "address_2": "SUITE 200",
            "city": "MILLERSBURG",
            "state": "OH",
            "postal_code": "446541568",
            "telephone_number": "330-674-3333",
            "fax_number": "330-674-4484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH PROFESSIONALS OF HOLMES COUNTY, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HEALTH PROFESSIONALS OF HOLMES COUNTY, INC",
        "enumeration_date": "2007-12-13",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "JUSTUS",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "330-674-1015",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2801427",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pomerene Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Millersburg, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.