| Innovative Healthcare | |
|
1835 E High St Ste 2 Springfield OH 45505-1276 | |
| (937) 322-8977 | |
| (937) 322-5837 |
| Full Name | Innovative Healthcare |
|---|---|
| Speciality | Family Medicine |
| Location | 1835 E High St Ste 2, Springfield, Ohio |
| Authorized Official Name and Position | Angelia K Montgomery (OFFICE MANAGER) |
| Authorized Official Contact | 9373228977 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Innovative Healthcare 1835 E High St Ste 2 Springfield OH 45505-1276 Ph: (937) 322-8977 | Innovative Healthcare 1835 E High St Ste 2 Springfield OH 45505-1276 Ph: (937) 322-8977 |
| NPI Number | 1013161215 |
|---|---|
| Provider Enumeration Date | 11/14/2008 |
| Last Update Date | 05/21/2024 |
| Medicare PECOS PAC ID | 4981887684 |
|---|---|
| Medicare Enrollment ID | O20110317000410 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013161215 | NPI | - | NPPES |
| 0053370 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Ferdinand S Fojas |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1013997568 PECOS PAC ID: 7719872688 Enrollment ID: I20040219000052 |
| Provider Name | Randal Scott Richardson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1518038314 PECOS PAC ID: 6800838558 Enrollment ID: I20050525000011 |
| Provider Name | Andreas Syllaba |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1063500932 PECOS PAC ID: 2769400985 Enrollment ID: I20051107000442 |
| Provider Name | Rohn T Kennington |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1497719637 PECOS PAC ID: 2163326877 Enrollment ID: I20080213000285 |
| Provider Name | Bryce D Arndt |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1669641452 PECOS PAC ID: 8123166444 Enrollment ID: I20091106000251 |
| Provider Name | Peter A Erhardt |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1427008119 PECOS PAC ID: 8224153473 Enrollment ID: I20100913000314 |
| Provider Name | Richard Joseph Maynard |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1477622942 PECOS PAC ID: 7719160977 Enrollment ID: I20110324000838 |
| Provider Name | Ondine Ngwashi Konteh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669725917 PECOS PAC ID: 7214167683 Enrollment ID: I20140304001180 |
| Provider Name | Estella Jo Wetzel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548698574 PECOS PAC ID: 3779714100 Enrollment ID: I20140327000560 |
| Provider Name | Mary Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326452939 PECOS PAC ID: 0345468575 Enrollment ID: I20140828002406 |
| Provider Name | Kelleen Porter |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1073009163 PECOS PAC ID: 9638421456 Enrollment ID: I20181005001653 |
| Provider Name | Eula Ann Doering |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326320474 PECOS PAC ID: 7719306471 Enrollment ID: I20200929002477 |
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