GENESIS MEDICAL GROUP LLC NPI 1437218526

NPI Information

  • NPI: 1437218526
  • Provider Name: GENESIS MEDICAL GROUP LLC
  • Classification: Family Medicine - 207QG0300X
  • Specialization: Geriatric Medicine
  • Entity Type: Organization
  • Doing Business As: CROOKSVILLE FAMILY CLINIC
  • CLIA Number: 36D1049149
  • Address: 712 CHINA STREET
    CROOKSVILLE FAMILY CLINIC INC.
    CROOKSVILLE, OH
    ZIP 43731
  • Phone: (740) 982-6872

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NPI Details

GENESIS MEDICAL GROUP LLC is a geriatric medicine family medicine in Crooksville, OH. The provider is 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. GENESIS MEDICAL GROUP LLC NPI is 1437218526. The provider is registered as an organization entity type.
The provider Is Doing Business As Crooksville Family Clinic.

The provider's business location address is:

712 CHINA STREET
CROOKSVILLE FAMILY CLINIC INC.
CROOKSVILLE, OH
ZIP 43731-124
Phone: (740) 982-6872
Fax: (740) 982-5551

The provider's authorized official is Paul D Masterson .
The authorized official title is Assist, Treasurer and has the following contact phone number (740) 454-4637.

The CLIA number assigned to this NPI record is 36D1049149 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 12/6/2006 and was last updated on 12/17/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QR1300XClinic/CenterRural HealthNo
2207RG0300XInternal MedicineGeriatric MedicineNo
3207QG0300XFamily MedicineGeriatric MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
12270313MEDICAIDOHIO
29296921MEDICARE PINOHIO
3363849MEDICARE PINOHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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