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GENESIS ELDERCARE PHYSICIAN SERVICES LLC
NPI 1366840811
Internal Medicine - Geriatric Medicine in Bryan, OH

Active since December 16, 2014
1104 WESLEY AVE, BRYAN, OH 43506(419) 636-5071 Get Directions Write a Review

NPPES record last updated: August 5, 2019. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Aug 5, 2019, Jul 10, 2018, Apr 13, 2018 (3 updates tracked since 2018).

About Genesis Eldercare Physician Services Llc NPPES

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

GENESIS ELDERCARE PHYSICIAN SERVICES LLC (NPI 1366840811) is a healthcare organization registered as a geriatric medicine in Bryan, Ohio and active in the NPI registry since December 2014. The organization lists Eric Shapiro, Vice President, as its authorized official.

NPPES Registry Identity

NPI1366840811
Entity TypeOrganization
Primary Taxonomy207RG0300X
Legal Business NameGENESIS ELDERCARE PHYSICIAN SERVICES LLC
Location Address1104 WESLEY AVEBryan, OH 43506
Mailing AddressPo Box 62946Baltimore, MD 21264-2946 · (410) 494-7607
Phone(419) 636-5071
Organization SubpartNo
Authorized OfficialEric ShapiroVice President · (410) 832-7790
Enumeration DateDecember 16, 2014
Last NPPES UpdateAugust 5, 20193 updates tracked since enumeration
✔ NPI 1366840811 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Geriatric MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207RG0300X
License✔ Licensed in OH · 201315000306
Definition
An internist who has 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.
1104 WESLEY AVE, Bryan, OH 43506
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

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

BRYAN HEALTHCARE AND REHABILITATION CENTER LLC
Skilled Nursing Facility
1104 WESLEY AVE
BRYAN, OH 43506
Williams County (419) 636-5071
SHAUNA WRIGHT COTA/L
Occupational Therapy Assistant
1104 WESLEY AVE
BRYAN, OH 43506
Williams County (419) 630-2809
HARBORSIDE OF OHIO LIMITED PARTNERSHIP
Skilled Nursing Facility
1104 WESLEY AVE
BRYAN, OH 43506
Williams County (419) 636-5071
JAIMI GEREN COTA/L
Occupational Therapy Assistant
1104 WESLEY AVE
BRYAN, OH 43506
Williams County (419) 636-5071
KENDRA KORTOKRAX M.S., CCC-SLP
Speech-Language Pathologist
1104 WESLEY AVE
BRYAN, OH 43506
Williams County (419) 636-5071
MRS. KARA EICHER COTA/L
Occupational Therapy Assistant
1104 WESLEY AVE
BRYAN, OH 43506
Williams County (419) 636-5071
MRS. TIFFANY RAE POLETTA COTA/L
Occupational Therapy Assistant
1104 WESLEY AVE
BRYAN, OH 43506
Williams County (419) 636-5071
MRS. SARA DYE PTA
Physical Therapy Assistant
1104 WESLEY AVE
BRYAN, OH 43506
Williams County (419) 636-5071

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 Genesis Eldercare Physician Services LLC's NPI number?

The NPI number for Genesis Eldercare Physician Services LLC is 1366840811. It was assigned to this organization in the NPPES registry on December 16, 2014.

Where is Genesis Eldercare Physician Services LLC located?

Genesis Eldercare Physician Services LLC is located at 1104 Wesley Ave, Bryan, OH 43506. The listed phone number is (419) 636-5071.

What is Genesis Eldercare Physician Services LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Geriatric Medicine, with taxonomy code 207RG0300X.

When was this NPI record last updated?

The NPPES record for Genesis Eldercare Physician Services LLC was last updated on August 5, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.