Individual provider Active NPI

John Baumeier, DO

  • Emergency Medicine Physician
  • Andover, OH
National Provider Identifier
1780632562
Registry record updated Jun 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
34-004810 Issued in OH
Practice address
476 S Main St
Andover, OH 44003-9602
Phone
(330) 841-4000
Fax
(330) 656-5901
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 34-004810 OH Primary

Addresses

Primary practice location

476 S Main St
Andover, OH 44003-9602

Mailing address

5700 Darrow Rd
Suite 106
Hudson, OH 44236-5021
Phone (330) 656-5911

Other identifiers 5

IdentifierTypeStateIssuer
000000383091OtherOHANTHEM
000000385524OtherOHANTHEM
101520330-0003OtherOHPENNSYLVANIA MEDICAID
0754321MedicaidOH
000000385522OtherOHANTHEM

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
I20050908000752 OH Practitioner - Emergency MedicinePractitioner - Family Practice 7517913890 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34-004810OHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mves Boardman LLC Emergency Medicine CurrentSince Oct 15, 2021 Accepting new patients
4M Emergency Systems Tod LLC Emergency Medicine CurrentSince Nov 1, 2006 Accepting new patients
4M Emergency Systems Andover LLC Emergency Medicine Past Accepting new patients
4M Emergency Systems LLC Emergency Medicine Past Accepting new patients
Mercy Health Youngstown LLC PastSince Nov 1, 2006 Accepting new patients
Mahoning Valley Emergency Specialists LLC Emergency Medicine Past Accepting new patients

Locations

5700 Darrow Rd
Ste 106
Hudson, OH 44236
Phone (330) 576-4295

667 Eastland Ave SE
Warren, OH 44484
Phone (330) 841-2378

1296 Tod Pl NW
Ste 200
Warren, OH 44485
Phone (330) 306-5040

1296 Tod Pl NW
Warren, OH 44485
Phone (330) 306-5010

8401 Market St
Youngstown, OH 44512
Phone (330) 729-2929

1044 Belmont Ave
Youngstown, OH 44504
Phone (330) 480-2182

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": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213142400000",
    "number": "1780632562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 DARROW RD",
            "address_2": "SUITE 106",
            "city": "HUDSON",
            "state": "OH",
            "postal_code": "442365021",
            "telephone_number": "330-656-5911",
            "fax_number": "330-656-5901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "476 S MAIN ST",
            "city": "ANDOVER",
            "state": "OH",
            "postal_code": "440039602",
            "telephone_number": "330-841-4000",
            "fax_number": "330-656-5901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUMEIER",
        "first_name": "JOHN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2008-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "34-004810",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000383091",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000385524",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PENNSYLVANIA MEDICAID",
            "identifier": "101520330-0003",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0754321",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000385522",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Andover, OH

Sources for this page

Verify at the official NPI Registry.