Enrollment ID	State	Provider type	PAC ID	Details
O20070702000432	OH	Part B Supplier - Clinic/Group Practice	6002916194	Receives reassigned benefits from 94 practitioners 15 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Berlin, OH; Sugarcreek, OH; Millersburg, OH; Loudonville, OH; Dover, OH

National Provider Directory

Specialties & licenses 1

NPPES NPI Registry

Specialty (taxonomy)	Code	License	State	Primary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP	174400000X	35.062576	OH	Primary

Addresses

NPPES NPI Registry

Primary practice location

981 Wooster Rd
Millersburg, OH 44654-1536

Mailing address

1261 Wooster Rd
Suite 200
Millersburg, OH 44654-1568
Phone (330) 674-3333

Other names 1

NPPES NPI Registry

Pomerene Cardio-vascular Services Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 24, 2013.

{
    "created_epoch": "1358985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358985600000",
    "number": "1871831909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1261 WOOSTER RD",
            "address_2": "SUITE 200",
            "city": "MILLERSBURG",
            "state": "OH",
            "postal_code": "446541568",
            "telephone_number": "330-674-3333",
            "fax_number": "330-763-2063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "981 WOOSTER RD",
            "city": "MILLERSBURG",
            "state": "OH",
            "postal_code": "446541536",
            "telephone_number": "330-674-1015",
            "fax_number": "330-763-2063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH PROFESSIONALS OF HOLMES COUNTY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-24",
        "last_updated": "2013-01-24",
        "status": "A",
        "authorized_official_last_name": "JUSTUS",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "330-674-1015",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CFO"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "OH",
            "license": "35.062576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pomerene Cardio-vascular Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Millersburg, OH

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2013; 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.