Lodi Community Care Center
Organization Active NPI Family Medicine Physician · Lodi, OH
NPI 1003849910 · NPPES record last updated Sep 11, 2014
Key facts
- NPI
- 1003849910
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- LODI COMMUNITY CARE CENTER
- Practice address
- 225 Elyria St
Lodi, OH 44254-1031 - Phone
- (330) 948-5533
- Fax
- (330) 948-2726
- NPI assigned
- Jul 7, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- LODI COMMUNITY HOSPITAL
Authorized official
- Name
- Mr. Thomas Whelan
- Title
- President
- Phone
- (330) 948-5500
Practitioners 13
-
Jeffrey A Burkey, MD
-
Todd David Houglan, M.D.
-
Mihaela R Iovi, M.D.
-
Erik Joseph Modlo, M.D.
-
Charlene Marie Nagel, NP-C
-
Brittny Queden, NP-C
-
Kristin Carrie Trill, NP-C
-
Loui Abdelghani, M.D
-
John A Walker II, MD
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 36D1059184 | Lodi Community Care Center | Certificate of waiver | Apr 28, 2027 |
National Provider Directory
- Part of
- Lodi Community Hospital
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes | ||
| Internal Medicine Physician |
207R00000X |
Addresses
Primary practice location
225 Elyria St
Lodi, OH 44254-1031
Mailing address
225 Elyria St
Lodi, OH 44254-1031
Phone (330) 948-5533
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801807870 | Other | OH | LODI COMMUNITY HOSPITAL TYPE 2 NPI # |
| 2396081 | Medicaid | OH |
Other providers in Lodi, OH
- Rafik Khalil
- Nicole A Klonaris
- Christel Kungl
- Laddgas, LLC
- Lake County Foot & Ankle Associates, LLC
- Lodi Community Hospital
- Lodi Community Hospital
- Lodi Community Hospital
- Lodi Community Hospital
- Lodi Family Chiropractic Corp
All providers in Lodi, OH · Family Medicine Physician in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 11, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.