NPIMap

Organization Active NPI

Healthsource of Ohio, Inc.

Doing business as HealthSource Georgetown Pediatrics and Family Practice

  • Primary Care Clinic/Center
  • Georgetown, OH
National Provider Identifier
1700980869
Registry record updated Aug 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
HEALTHSOURCE OF OHIO, INC.
Doing business as
HealthSource Georgetown Pediatrics and Family Practice
HealthSource: Georgetown Pediatrics
Practice address
631 E State St
Georgetown, OH 45121-1437
Phone
(937) 378-6387
Fax
(937) 378-4253
NPI assigned
Sep 11, 2006
Last updated
Aug 28, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2026

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

Authorized official

Name
Joseph W Prather II, MD
Title
Ceo
Phone
(513) 707-4041

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

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 names 2

  • HealthSource Georgetown Pediatrics and Family Practice Doing business as
  • HealthSource: Georgetown Pediatrics Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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…

Other NPIs on the same Medicare enrollment 20

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

View all 20

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 74

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 74

NPI Registry JSON

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

{
    "created_epoch": "1157932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787875200000",
    "number": "1700980869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 WARDS CORNER RD STE 200",
            "city": "LOVELAND",
            "state": "OH",
            "postal_code": "451406966",
            "telephone_number": "513-074-0417",
            "fax_number": "513-576-1020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 E STATE ST",
            "city": "GEORGETOWN",
            "state": "OH",
            "postal_code": "451211437",
            "telephone_number": "937-378-6387",
            "fax_number": "937-378-4253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHSOURCE OF OHIO, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-11",
        "last_updated": "2026-08-28",
        "certification_date": "2026-08-28",
        "status": "A",
        "authorized_official_last_name": "PRATHER II",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "513-707-4041",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HealthSource Georgetown Pediatrics and Family Practice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "HealthSource: Georgetown Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Georgetown, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2026; 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.