NPIMap

Organization Active NPI

Bios Wellness Clinic Inc.

  • Urgent Care Clinic/Center
  • Youngstown, OH
National Provider Identifier
1730775511
Registry record updated Dec 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
BIOS WELLNESS CLINIC INC.
Practice address
238 S Meridian Rd
Youngstown, OH 44509-2925
Phone
(330) 318-3436
Fax
(330) 752-9284
NPI assigned
Dec 16, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2020

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

Authorized official

Name
Desirae ThompsonNPI 1134664592
Title
Chief Operating Officer
Phone
(330) 318-3436

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

238 S Meridian Rd
Youngstown, OH 44509-2925

Mailing address

238 S Meridian Rd
Youngstown, OH 44509-2925
Phone (330) 318-3436

Other identifiers 2

IdentifierTypeStateIssuer
0409818MedicaidOH
0082458MedicaidOH

Other names 1

  • Bios Wellness Clinic Inc. Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL https://login.cbh3.crediblebh.com/Login.html? Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221213000695 OH Part B Supplier - Clinic/Group Practice 7214306323 Receives reassigned benefits from 3 practitioners
1 other NPI on this enrollment
Practice locations: Youngstown, OH

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

Locations

238 S Meridian Rd
Ste B
Youngstown, OH 44509
Phone (330) 318-3436

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1608076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608076800000",
    "number": "1730775511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "238 S MERIDIAN RD",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445092925",
            "telephone_number": "330-318-3436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "238 S MERIDIAN RD",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445092925",
            "telephone_number": "330-318-3436",
            "fax_number": "330-752-9284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIOS WELLNESS CLINIC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-16",
        "last_updated": "2020-12-16",
        "certification_date": "2020-12-16",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "DESIRAE",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "330-318-3436"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0409818",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0082458",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://login.cbh3.crediblebh.com/Login.html?",
            "affiliation": "N",
            "endpointDescription": "Electronic Health Records",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "contentOtherDescription": "Client Portal",
            "address_1": "238 S Meridian Rd",
            "city": "Youngstown",
            "state": "OH",
            "country_code": "US",
            "postal_code": "445092925",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Bios Wellness Clinic Inc.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Youngstown, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2020; 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.