GENESIS MEDICAL GROUP LLC (NPI# 1437218526) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437218526 |
| Entity Type | Organization |
| Organization Name | GENESIS MEDICAL GROUP LLC |
| Other Organization Name | CROOKSVILLE FAMILY CLINIC |
| Practice Address |
712 China Street Crooksville Family Clinic Inc. Crooksville OH 43731-1124 |
| Mailing Address |
945 Bethesda Drive Suite 200 Zanesville OH 43701-1880 |
| Practice Telephone | 7409826872 |
| Practice Fax Number | 7409825551 |
| Mailing Telephone | 7404544788 |
| Mailing Fax Number | 7404506157 |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2013-12-17 |
| Authorized Official Name | MR. PAUL D MASTERSON (ASSIST, TREASURER) |
| Authorized Official Telephone | 7404544637 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities | ||
| N | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
Allopathic & Osteopathic Physicians | ||
| Y | 207QG0300X |
Family Medicine Specialization: Geriatric Medicine |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 2270313 | 05 |
| Other Name | Type Code |
|---|---|
| Crooksville Family Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013214014 | Genesis Medical Group LLC | Prosthetic/Orthotic Supplier | 10802 Se Washington St, Portland, OR 97216-3118 | 2011-02-28 |
| 1063663433 | Genesis Medical Group LLC | Allergy & Immunology | 945 Bethesda Dr Ste 200, Zanesville, OH 43701-1880 | 2008-10-03 |
| Street Address |
712 CHINA STREET CROOKSVILLE FAMILY CLINIC INC. |
| City | CROOKSVILLE |
| State | OH |
| Zip Code | 43731-1124 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841757754 | Jeffrey Houston | Occupational Therapy Assistant | Framer Mobile Home Park, Lot 4, Crooksville, OH 43731 | 2019-02-27 |
| 1326503111 | Zachary Patton | Specialist/Technologist | 4965 Ceramic Way, Crooksville, OH 43731 | 2019-02-05 |
| 1023480670 | Debra Charlene Hurst | Licensed Practical Nurse | 195 S Buckeye St, Crooksville, OH 43731 | 2015-10-22 |
| 1780824086 | Renee Ann Clutter | Licensed Practical Nurse | 13952 Third Street, Crooksville, OH 43731 | 2009-02-26 |
| 1356471494 | Crooksville Exempted Village Schools | Local Education Agency (LEA) | 4065 School Drive, Crooksville, OH 43731 | 2007-03-07 |
| 1598905069 | Crooksville Exempted Village School District | Local Education Agency (LEA) | 4065 School Drive, Crooksville, OH 43731 | 2009-02-24 |
| 1942302112 | Marina A Parker | Physician Assistant | 712 China St, Crooksville, OH 43731-0159 | 2006-09-01 |
| 1942770607 | Jessica Amanda Swain | Case Manager/Care Coordinator | 350 Bennett St, Crooksville, OH 43731-1004 | 2018-11-26 |
| 1518069210 | Coler Drug New Lexington Ltd | Durable Medical Equipment & Medical Supplies | 120 S Buckeye St, Crooksville, OH 43731-1015 | 2006-09-02 |
| 1619581022 | Mark Andrew Hendrickson | Pharmacist | 120 S Buckeye St, Crooksville, OH 43731-1015 | 2020-09-02 |
| Find all providers in zip 43731 | ||||
| Taxonomy Code | 207QG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Geriatric Medicine |
| A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://wwwtheabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730248816 | Geriatric Associates of Zanesville | Family Medicine | 712 China St, Crooksville, OH 43731-1124 | 2006-12-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922645779 | Francis Dapaah | Family Medicine | 1264 Brainard Rd, Lyndhurst, OH 44124-1404 | 2019-11-27 |
| 1255832275 | Primary Care Partners of Ohio | Family Medicine | 726 E Main St Ste F205, Lebanon, OH 45036 | 2018-02-25 |
| 1780009928 | Js Aesthetics | Family Medicine | 2400 Passage Key Trl, Xenia, OH 45385-9212 | 2014-02-25 |
| 1821422486 | Healthserve Medical Group LLC | Family Medicine | 2939 Kenny Rd Ste 200, Columbus, OH 43221-2406 | 2013-08-30 |
| 1902152366 | Mason Family Health Center LLC | Family Medicine | 7808 Derbyshire Ct, Liberty Township, OH 45044-9049 | 2012-08-02 |
| 1548539976 | Eva Ray Lefton | Family Medicine | 16 Deerfield Ln, Beachwood, OH 44122-7502 | 2011-12-13 |
| 1508189499 | Senior Care Physicians, Inc. | Family Medicine | 1745 Indian Wood Cir Ste 252, Maumee, OH 43537-4168 | 2010-03-05 |
| 1639404171 | Midwest Dysphagia Consultants, LLC | Family Medicine | 5710 Wooster Pike Ste 102, Cincinnati, OH 45227-4520 | 2009-10-15 |
| 1457589087 | John Tychonievich | Family Medicine | 2222 Welcome Pl, Columbus, OH 43209-7813 | 2009-06-22 |
| 1235311358 | Licking Memorial Professional Corp. | Family Medicine | 17 Forry St, Newark, OH 43055-4004 | 2007-11-30 |
| Find all providers with the same taxonomy | ||||
| City | CROOKSVILLE |
| Zip Code | 43731 |
Please comment or provide details below to improve the information on GENESIS MEDICAL GROUP LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.