SCIOTO ADVANTAGE HEALTH & WELLNESS CENTER
NPI 1063086411
Clinic/Center - Primary Care in New Boston, OH

Active since May 19, 2021CLIA 36D2135601 · Waiver
3879 RHODES AVE, NEW BOSTON, OH 45662(740) 354-0292(740) 354-0293 Get Directions Write a Review

NPPES record last updated: August 16, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Aug 16, 2022, May 19, 2021 (2 updates tracked since 2021).

About Scioto Advantage Health & Wellness Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SCIOTO ADVANTAGE HEALTH & WELLNESS CENTER (NPI 1063086411) is a healthcare organization registered as a primary care in New Boston, Ohio and active in the NPI registry since May 2021. The organization holds a CLIA Waiver certificate valid through August 23, 2027 and lists Jonathan B Leizman, President, as its authorized official.

NPPES Registry Identity

NPI1063086411
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NamePREMISE HEALTH OF OHIO MEDICAL, P.A
Location Address3879 RHODES AVENew Boston, OH 45662-6002
Mailing Address5500 Maryland Way Ste 120Brentwood, TN 37027-4993
Fax(740) 354-0293
Organization SubpartNo
Authorized OfficialJonathan B LeizmanPresident · (216) 479-9063
Enumeration DateMay 19, 2021
Last NPPES UpdateAugust 16, 20222 updates tracked since enumeration
NPPES CertifiedAugust 16, 2022
NPI 1063086411 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
3879 RHODES AVE, New Boston, OH 45662

Other Names 1

Doing Business AsScioto Advantage Health & Wellness Center

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 36D2135601

Premise Health Of Ohio Medical, PA · New Boston, OH
Active · expires Aug 23, 2027
CLIA Number36D2135601
Laboratory TypePhysician Office
Certificate Effective DateAugust 24, 2025
Certificate Expiration DateAugust 23, 2027
Laboratory DirectorSara Mccullough
Laboratory Phone(740) 354-0292
Laboratory LocationPremise Health Of Ohio Medical, PA3879 Rhodes Ave, New Boston, OH 45662
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Clinic/Center (Multi-Specialty)
3879 RHODES AVE
NEW BOSTON, OH 45662
Nurse Practitioner (Family)
3879 RHODES AVE
NEW BOSTON, OH 45662
Family Medicine (Adult Medicine)
3879 RHODES AVE
NEW BOSTON, OH 45662
Nurse Practitioner (Family)
3879 RHODES AVE
NEW BOSTON, OH 45662

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Premise Health Of Ohio Medical, P.A's NPI number?

The NPI number for Premise Health Of Ohio Medical, P.A is 1063086411. It was assigned to this organization in the NPPES registry on May 19, 2021. The provider is doing business as Scioto Advantage Health & Wellness Center.

Where is Premise Health Of Ohio Medical, P.A located?

Premise Health Of Ohio Medical, P.A is located at 3879 Rhodes Ave, New Boston, OH 45662. The listed phone number is (740) 354-0292.

What is Premise Health Of Ohio Medical, P.A's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Does Premise Health Of Ohio Medical, P.A hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 36D2135601) is associated with this NPI, valid through August 23, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Premise Health Of Ohio Medical, P.A was last updated on August 16, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.