NPIMap

Organization Active NPI

Hocking Valley Medical Group, Inc.

  • Family Medicine Physician
  • Logan, OH
National Provider Identifier
1801994827
Registry record updated Aug 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
HOCKING VALLEY MEDICAL GROUP, INC.
Practice address
601 State Route 664 N
Logan, OH 43138-8541
Phone
(740) 380-8140
Fax
(740) 380-8150
NPI assigned
Sep 21, 2006
Last updated
Aug 20, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2025

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

Authorized official

Name
Kimberly Brown
Title
Credentialing Specialist
Phone
(740) 380-8350

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X OH
Surgical Physician Assistant 363AS0400X OH
Nurse Practitioner 363L00000X OH
Family Medicine Physician 207Q00000X OH Primary
Orthopaedic Surgery Physician 207X00000X OH
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X OH
Pediatrics Physician 208000000X OH
Psychiatry Physician 2084P0800X OH
Surgery Physician 208600000X OH
General Practice Physician 208D00000X OH

Addresses

Primary practice location

601 State Route 664 N
Logan, OH 43138-8541

Mailing address

PO Box 228
Logan, OH 43138-0228
Phone (740) 385-7564

Other practice location 1

819 State Route 664 N
Logan, OH 43138-8540
Phone (740) 380-8171

Other practice location 2

1383 W Hunter St
Logan, OH 43138-1013
Phone (740) 385-0202

Other identifiers 2

IdentifierTypeStateIssuer
0261756MedicaidOH
023303500OtherOHBLACK LUNG

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040505000146 OH Part B Supplier - Clinic/Group Practice 0345238622 Receives reassigned benefits from 42 practitioners
Practice locations: Logan, OH

National Provider Directory

National Provider Directory

Locations

1389 W Hunter St
Logan, OH 43138
Phone (740) 385-2197

819 State Route 664 N
Logan, OH 43138
Phone (740) 380-8140

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 48

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 48

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755648000000",
    "number": "1801994827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 228",
            "city": "LOGAN",
            "state": "OH",
            "postal_code": "431380228",
            "telephone_number": "740-385-7564",
            "fax_number": "740-385-7566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 STATE ROUTE 664 N",
            "city": "LOGAN",
            "state": "OH",
            "postal_code": "431388541",
            "telephone_number": "740-380-8140",
            "fax_number": "740-380-8150"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "819 State Route 664 N",
            "address_purpose": "LOCATION",
            "city": "Logan",
            "state": "OH",
            "postal_code": "431388540",
            "country_code": "US",
            "telephone_number": "740-380-8171",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1383 W Hunter St",
            "address_purpose": "LOCATION",
            "city": "Logan",
            "state": "OH",
            "postal_code": "431381013",
            "country_code": "US",
            "telephone_number": "740-385-0202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HOCKING VALLEY MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-20",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "740-380-8350"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": null,
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "OH",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0261756",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLACK LUNG",
            "identifier": "023303500",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Logan, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2025; 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.