NPIMap

Organization Active NPI

Healthsource of Ohio Inc

Doing business as HealthSource Wards Corner

  • Federally Qualified Health Center (FQHC)
  • Loveland, OH
National Provider Identifier
1710775937
Registry record updated Mar 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
HEALTHSOURCE OF OHIO INC
Doing business as
HealthSource Wards Corner
Practice address
455 Wards Corner Rd Ste 200
Loveland, OH 45140-9062
Phone
(513) 688-8580
Fax
(513) 688-8591
NPI assigned
Apr 28, 2025
Last updated
Mar 26, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2026

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

455 Wards Corner Rd Ste 200
Loveland, OH 45140-9062

Mailing address

424 Wards Corner Rd Ste 200
Loveland, OH 45140-6966
Phone (513) 707-4041

Other identifiers 1

IdentifierTypeStateIssuer
0142397MedicaidOH

Other names 1

  • HealthSource Wards Corner Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250919003356 OH Part A Provider - Federally Qualified Health Center (FQHC) 2264328749 Practice locations: Loveland, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1710775937. Details of each certification follow.

Federally qualified health center certification: CCN D21100

Legal name
HEALTHSOURCE OF OHIO, INC.
Doing business as
HEALTHSOURCE WARDS CORNER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 19, 2025
Last certification
Sep 19, 2025
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
455 Wards Corner Rd
Ste 200
Loveland, OH 45140-3800

Other NPIs with the same Medicare PAC ID 24

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 24

National Provider Directory

National Provider Directory
Tax ID family
Southern Ohio HLTH Serv45 organizations share this tax ID, including this one

Other organizations with this tax ID 44

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

View all 44

Locations

4627 Aicholtz Rd
Cincinnati, OH 45244
Phone (513) 753-2820

Ownership & related parties

All disclosed owners & managing parties 10

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Gail Koford Individual Corporate DirectorBoard Member May 28, 2024
Douglas McDonald Individual Corporate DirectorBoard Member Jan 25, 2021
Patrick Hayes Individual Corporate DirectorBoard Member Jan 30, 2025
Stephen Hood Individual Corporate DirectorBoard Member Mar 31, 2022
Joseph W Prather Individual Corporate OfficerCeo May 28, 2024
W-2 Managing EmployeeCeo May 28, 2024
Tiffany Mattingly Individual Corporate DirectorBoard Member Apr 28, 2022
Mark McAndrew Individual Corporate DirectorBoard Member May 25, 2017
Jina L Bohl Individual Corporate DirectorBoard Member Mar 28, 2019
Konstantinos Elefter Individual Corporate DirectorBoard Member Dec 10, 2020
Cynthia L. Wright Sellers Individual Corporate DirectorBoard Member Jun 29, 2017

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Healthsource Batavia Family PracticeBatavia, OH, CCN 361820 Federally qualified health center Operational/Managerial Control (100%) Oct 1, 1976

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 15

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 15

NPI Registry JSON

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

{
    "created_epoch": "1745798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774483200000",
    "number": "1710775937",
    "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": "513-707-4041",
            "fax_number": "513-576-1020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 WARDS CORNER RD STE 200",
            "city": "LOVELAND",
            "state": "OH",
            "postal_code": "451409062",
            "telephone_number": "513-688-8580",
            "fax_number": "513-688-8591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHSOURCE OF OHIO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-28",
        "last_updated": "2026-03-26",
        "certification_date": "2026-03-26",
        "status": "A",
        "authorized_official_last_name": "PRATHER",
        "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": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0142397",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HealthSource Wards Corner",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Loveland, OH

Sources for this page

Verify at the official NPI Registry.