GENESIS PROFESSIONAL CORP NPI 1497755623

NPI Information

NPI: 1497755623
Provider Name: GENESIS PROFESSIONAL CORP
Classification: General Practice - 208D00000X
Entity Type: Organization

CLIA Number: 36D2234780

Address:
800 FOREST AVE
ZANESVILLE, OH
ZIP 43701
Phone: (740) 454-0366
Get Directions

GENESIS PROFESSIONAL CORP is a general practice in Zanesville, OH. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee GENESIS PROFESSIONAL CORP NPI is 1497755623. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

800 FOREST AVE
ZANESVILLE, OH
ZIP 43701-882
Phone: (740) 454-0366
Fax: (740) 454-3790

The provider's authorized official is Al Burns .
The authorized official title is President and has the following contact phone number (740) 454-0366.

The CLIA number assigned to this NPI record is 36D2234780 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/29/2005 and was last updated on 11/15/2007.

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 State	Primary
1	207KA0200X	Allergy & Immunology	Allergy		No
2	207LP2900X	Anesthesiology	Pain Medicine		No
3	207Q00000X	Family Medicine		OHIO	No
4	207RI0200X	Internal Medicine	Infectious Disease		No
5	207RC0000X	Internal Medicine	Cardiovascular Disease		No
6	207RI0011X	Internal Medicine	Interventional Cardiology		No
7	208VP0000X	Pain Medicine	Pain Medicine		No
8	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery)			No
9	208600000X	Surgery			No
10	207T00000X	Neurological Surgery			No
11	207Y00000X	Otolaryngology			No
12	208D00000X	General Practice			Yes

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
1	GE9306542	MEDICARE ID-TYPE UNSPECIFIED	OHIO
2	9303542	MEDICARE PIN	OHIO
3	GE9303542	MEDICARE PIN	OHIO
4	GE9303541	MEDICARE PIN	OHIO
5	2467343	MEDICAID	OHIO
6	9303541	MEDICARE PIN	OHIO

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: 5/5/2024

NPI Synchronization or Removal

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