HealthSource: Georgetown Pediatrics and Family Practice – Federally Qualified Health Center (FQHC), NPI 1255372207
Federally Qualified Health Center (FQHC)
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for HealthSource: Georgetown Pediatrics and Family Practice
424 WARDS CORNER RD STE 200
LOVELAND, OH 451406966
Phone: (513) 707-4041
Fax: (513) 576-1020
Type: Mailing
631, East State Street, Georgetown Historic District, Georgetown, Brown County, Ohio, 45121, United States
GEORGETOWN, OH 451211437
Phone: (937) 378-6387
Fax: (937) 378-4253
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2007-04-24
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2025-12-31 (161 days ago).
Enrollment records
1
Earliest due date
2025-12-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20070424000414 | O | Federally Qualified Health Center (Fqhc) | OH | 2025-12-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 45140)
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