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Organization Active NPI

Interim Healthcare Palliative Care of the Midwest, Inc

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Worthington, OH
National Provider Identifier
1851911440
Registry record updated Aug 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Family Medicine) PhysicianTaxonomy code 207QH0002X
Legal business name
INTERIM HEALTHCARE PALLIATIVE CARE OF THE MIDWEST, INC
Practice address
300 W Wilson Bridge Rd Ste 250
Worthington, OH 43085-2289
Phone
(614) 436-9404
NPI assigned
Apr 23, 2020
Last updated
Aug 29, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2024

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

Authorized official

Name
Thomas J Dimarco
Title
Ceo
Phone
(614) 436-9404

Specialties & licenses 11

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X NU
Adult Health Nurse Practitioner 363LA2200X NU
Family Nurse Practitioner 363LF0000X NU
Clinical Psychologist 103TC0700X NU
Clinical Social Worker 1041C0700X NU
Family Medicine Physician 207Q00000X NU
Internal Medicine Physician 207R00000X NU
Geriatric Medicine (Internal Medicine) Physician 207RG0300X NU
In Home Supportive Care Agency 253Z00000X NU
Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X NU Primary
Hospice and Palliative Medicine (Physical Medicine & Rehabilitation) Physician 2081H0002X NU

Addresses

Primary practice location

300 W Wilson Bridge Rd Ste 250
Worthington, OH 43085-2289

Mailing address

300 W Wilson Bridge Rd Ste 250
Worthington, OH 43085-2289
Phone (614) 436-9404

Other practice location 1

3745 Shawnee Rd Ste 108
Lima, OH 45806-1665
Phone (800) 615-5224

Other practice location 2

300 W Wilson Bridge Rd Ste 250
Worthington, OH 43085-2289
Phone (614) 436-9404

Other practice location 3

900 Sharon Valley Rd
Newark, OH 43055-2804
Phone (800) 615-5224

Other practice location 4

7009 Taylorsville Rd Ste C
Huber Heights, OH 45424-3176
Phone (800) 615-5224

Other practice location 5

499 S 2nd St
Coshocton, OH 43812-1906
Phone (800) 615-6224

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201201000816 OH Part B Supplier - Clinic/Group Practice 4688085301 Receives reassigned benefits from 5 practitioners
Practice locations: Huber Heights, OH; Lima, OH; Worthington, OH; Zanesville, OH

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Interim Healthcare Palliative Care of the Midwest Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 5

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": "1587600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724889600000",
    "number": "1851911440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W WILSON BRIDGE RD STE 250",
            "city": "WORTHINGTON",
            "state": "OH",
            "postal_code": "430852289",
            "telephone_number": "614-436-9404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W WILSON BRIDGE RD STE 250",
            "city": "WORTHINGTON",
            "state": "OH",
            "postal_code": "430852289",
            "telephone_number": "614-436-9404"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3745 Shawnee Rd Ste 108",
            "address_purpose": "LOCATION",
            "city": "Lima",
            "state": "OH",
            "postal_code": "458061665",
            "country_code": "US",
            "telephone_number": "800-615-5224",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 W Wilson Bridge Rd Ste 250",
            "address_purpose": "LOCATION",
            "city": "Worthington",
            "state": "OH",
            "postal_code": "430852289",
            "country_code": "US",
            "telephone_number": "614-436-9404",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "900 Sharon Valley Rd",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "OH",
            "postal_code": "430552804",
            "country_code": "US",
            "telephone_number": "800-615-5224",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7009 Taylorsville Rd Ste C",
            "address_purpose": "LOCATION",
            "city": "Huber Heights",
            "state": "OH",
            "postal_code": "454243176",
            "country_code": "US",
            "telephone_number": "800-615-5224",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "499 S 2nd St",
            "address_purpose": "LOCATION",
            "city": "Coshocton",
            "state": "OH",
            "postal_code": "438121906",
            "country_code": "US",
            "telephone_number": "800-615-6224",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "INTERIM HEALTHCARE PALLIATIVE CARE OF THE MIDWEST, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-23",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A",
        "authorized_official_last_name": "DIMARCO",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "614-436-9404"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2081H0002X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Hospice and Palliative Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worthington, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2024; 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.