Independence Healthcare Llc is a medicare enrolled primary clinic (Clinic/center) in Buckeye Lake, Ohio. The current practice location for Independence Healthcare Llc is 4595 Walnut Rd Ste L, Buckeye Lake, Ohio. For appointments, you can reach them via phone at
(740) 822-0080. The mailing address for Independence Healthcare Llc is 4595 Walnut Rd Ste L, Buckeye Lake, Ohio and phone number is (740) 822-0080.
Independence Healthcare Llc is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its
NPI number is 1699556746. This medical practice
accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at
(740) 822-0080.
Primary Care Clinic Profile
| Full Name | Independence Healthcare Llc |
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| Speciality | Clinic/Center |
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| Location | 4595 Walnut Rd Ste L, Buckeye Lake, Ohio |
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| Authorized Official Name and Position | Khadie Muriel Thomas (NURSE PRACTITIONER) |
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| Authorized Official Contact | 6148936800 |
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| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
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Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Independence Healthcare Llc
4595 Walnut Rd Ste L
Buckeye Lake
OH 43008-7909
Ph: (740) 822-0080 | Independence Healthcare Llc
4595 Walnut Rd Ste L
Buckeye Lake
OH 43008-7909
Ph: (740) 822-0080 |
NPI Details:
| NPI Number | 1699556746 |
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| Provider Enumeration Date | 10/12/2023 |
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| Last Update Date | 07/05/2024 |
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Medicare PECOS Information:
| Medicare PECOS PAC ID | 7315381498 |
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| Medicare Enrollment ID | O20240216000888 |
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Medical Identifiers
Medical identifiers for Independence Healthcare Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1699556746 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Independence Healthcare Llc acts as a billing entity for following providers:
| Provider Name | Khadie Thomas |
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| Provider Type | Practitioner - Nurse Practitioner |
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| Provider Identifiers | NPI Number: 1831679612
PECOS PAC ID: 3072849629
Enrollment ID: I20190719002359 |
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