Healthsource of Ohio, Inc.
Organization Active NPI Primary Care Clinic/Center · Georgetown, OH
NPI 1700980869 · NPPES record last updated Aug 28, 2026
Key facts
- NPI
- 1700980869
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Primary Care Clinic/Center 261QP2300X
- Legal business name
- HEALTHSOURCE OF OHIO, INC.
- Practice address
- 631 E State St
Georgetown, OH 45121-1437 - Phone
- (937) 378-6387
- Fax
- (937) 378-4253
- NPI assigned
- Sep 11, 2006
- Organization subpart
- No
Authorized official
- Name
- Joseph W Prather II, MD
- Title
- Ceo
- Phone
- (513) 707-4041
Other NPIs on the same Medicare enrollment 20
Practitioners 71
-
Kathleen M Adkins, NURSE PRACTITIONER
-
Shana Ryan Alexander, M.D.
-
Anya C. Bauman, MD
-
Jessica Beebe, DO
-
Sujata Bhattacharjee, CNP
-
Holly Binnig, MD
-
Mary A Bishop, MD
-
Theresa A Brockman, LISW
-
Michael Bruner, PSYD
-
Stephanie Kristen Burkhard, M.A., QMHP
-
Kane Carlock, LMHCA
-
Roger Kai-Di Chang, M.D.
-
Myanh Cong, DDS
-
Hannah Dearworth, DO
-
Sahara Dawn Dorsey, BC-FNP
-
Stephanie S Flynn, M.D.
-
Josie Ann Gast, PA-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140521002611 | OH | Part B Supplier - Clinic/Group Practice | 2264328749 |
Receives reassigned benefits from 78 practitioners 21 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Hillsboro, OH; Lebanon, OH; Loveland, OH; Mount Orab, OH; New Richmond, OH; Seaman, OH; Washington Court House, OH; Williamsburg, OH… |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | Yes |
Addresses
Primary practice location
631 E State St
Georgetown, OH 45121-1437
Mailing address
424 Wards Corner Rd Ste 200
Loveland, OH 45140-6966
Phone (513) 074-0417
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0598349 | Medicaid | OH |
Other names
- HealthSource Georgetown Pediatrics and Family Practice
- HealthSource: Georgetown Pediatrics
Other providers in Georgetown, OH
- Jennifer L Hartline
- Dawn J Haynes
- Healthsource of Ohio, Inc.
- Healthsource of Ohio, Inc.
- Healthsource of Ohio, Inc.
- Jack Helvey
- Sandra K Hirons
- Brad Allen Hively
- Barron W. Hixon
- Shannon Nicole Hornschemeier
All providers in Georgetown, OH · Primary Care Clinic/Center in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 28, 2026. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.