Individual provider Active NPI

Justin D Coomes, M.D.

  • Emergency Medicine Physician
  • Fairfield, OH
National Provider Identifier
1730322413
Registry record updated Jan 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
35.099677 Issued in OH
Practice address
3000 Mack Rd
Fairfield, OH 45014-5335
Phone
(513) 603-8128
NPI assigned
Apr 10, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X TP610 KY
Emergency Medicine Physician 207P00000X 35.099677 OH Primary

Addresses

Primary practice location

3000 Mack Rd
Fairfield, OH 45014-5335

Mailing address

4535 Dressler Rd NW
Canton, OH 44718-2545
Phone (330) 493-4443

Other practice location 1

4535 Dressler Rd NW
Canton, OH 44718-2545
Phone (330) 493-4443

Other identifiers 2

IdentifierTypeStateIssuer
TP610OtherKYKENTUCKY BOARD OF MEDICAL LICENSURE
35.099677OtherOHSTATE MEDICAL BOARD OF OHIO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120730000536 OH Practitioner - Emergency Medicine 0244410314 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.9 of 100Reported as group
Quality
91.17
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35.099677OHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Physicians of Champaign County LTD Emergency Medicine CurrentSince Jun 18, 2019 Accepting new patients
Emergency Medicine Physicians of Cincinnati, LTD. Emergency Medicine CurrentSince Sep 10, 2015 Accepting new patients
University Medical Center, Inc Emergency Medicine Past Accepting new patients
Emergency Medicine Physicians of Iredell County, PLLC Emergency Medicine Past Accepting new patients
Emergency Medicine Physicians of Hamilton County, LTD. Emergency Medicine Past Accepting new patients
Emergency Medicine Physicians of York County, LTD Emergency Medicine Past Accepting new patients

Locations

4535 Dressler Rd NW
Canton, OH 44718
Phone (330) 994-4409

3300 Mercy Health Blvd
Cincinnati, OH 45211
Phone (513) 215-1114

7500 State Rd
Cincinnati, OH 45255
Phone (513) 624-4034

3000 Mack Rd
Hamilton, OH 45014
Phone (513) 870-7000

100 Medical Center Dr
Springfield, OH 45504
Phone (937) 523-1000

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1239321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609977600000",
    "number": "1730322413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4535 DRESSLER RD NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182545",
            "telephone_number": "330-493-4443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 MACK RD",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450145335",
            "telephone_number": "513-603-8128"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4535 Dressler Rd NW",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "OH",
            "postal_code": "447182545",
            "country_code": "US",
            "telephone_number": "330-493-4443",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOMES",
        "first_name": "JUSTIN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-10",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "TP610",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35.099677",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KENTUCKY BOARD OF MEDICAL LICENSURE",
            "identifier": "TP610",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL BOARD OF OHIO",
            "identifier": "35.099677",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, OH

Sources for this page

Verify at the official NPI Registry.