NPIMap

Organization Active NPI

Omni Health Services, Inc.

  • Peer Specialist
  • Hazleton, PA
National Provider Identifier
1811468127
Registry record updated Nov 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
Legal business name
OMNI HEALTH SERVICES, INC.
Practice address
1730 E Broad St Ste 4
Hazleton, PA 18201-5657
Phone
(570) 455-0322
Fax
(570) 455-0566
NPI assigned
Dec 13, 2018
Last updated
Nov 29, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2021

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

Authorized official

Name
Michael M ThevarNPI 1548414998
Title
President
Phone
(215) 997-2000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU
Psychiatry Physician 2084P0800X NU
Peer Specialist 175T00000X NU Primary

Addresses

Primary practice location

1730 E Broad St Ste 4
Hazleton, PA 18201-5657

Mailing address

PO Box 454
Montgomeryville, PA 18936-0454
Phone (215) 997-2000

Other identifiers 1

IdentifierTypeStateIssuer
1020016630010MedicaidPA

National Provider Directory

National Provider Directory
Tax ID family
Omni Health Services Inc24 organizations share this tax ID, including this one

Other organizations with this tax ID 23

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

View all 23

Locations

1747 E Broad St
#B
Hazleton, PA 18201
Phone (570) 454-8404

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1544659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638144000000",
    "number": "1811468127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 454",
            "city": "MONTGOMERYVILLE",
            "state": "PA",
            "postal_code": "189360454",
            "telephone_number": "215-997-2000",
            "fax_number": "215-997-2282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 E BROAD ST STE 4",
            "city": "HAZLETON",
            "state": "PA",
            "postal_code": "182015657",
            "telephone_number": "570-455-0322",
            "fax_number": "570-455-0566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMNI HEALTH SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-13",
        "last_updated": "2021-11-29",
        "certification_date": "2021-11-29",
        "status": "A",
        "authorized_official_last_name": "THEVAR",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "215-997-2000"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1020016630010",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazleton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.