Individual provider Active NPI

Samuel D Forshey, MSN, FNP

  • Nurse Practitioner
  • Toledo, OH
National Provider Identifier
1063006435
Registry record updated Nov 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F08201188 Issued in OH
Practice address
1125 Hospital Dr
Toledo, OH 43614-8001
Phone
(419) 383-3761
NPI assigned
Feb 25, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F08201188 OH Primary

Addresses

Primary practice location

1125 Hospital Dr
Toledo, OH 43614-8001

Mailing address

4510 Dorr St
Toledo, OH 43615-4040
Phone (419) 383-5334

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211112001461 OH Practitioner - Nurse Practitioner 9638568637 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Toledo College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Promedica Central PhysiciansGroup PAC ID 2365348190, 785 clinicians

Practice addresses (Care Compare)

2130 W Central Ave
Toledo, OH 43606-3834
Phone (419) 291-4590

Hospital & facility affiliations

  • Promedica Toledo Hospital Hospital, Toledo, OH, CCN 360068
  • Mercy St Vincent Medical Center Hospital, Toledo, OH, CCN 360112
  • Promedica Defiance Regional Hospital Hospital, Defiance, OH, CCN 361328

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F08201188OHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Promedica Central Physicians Nurse Practitioner CurrentSince Jan 9, 2022 Accepting new patients
Promedica Central Physicians CurrentSince Jan 9, 2022 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

2865 N Reynolds Rd
Ste 160
Toledo, OH 43615
Phone (419) 578-4260

2130 W Central Ave
Toledo, OH 43606
Phone (419) 291-4590

3000 Arlington Ave
Toledo, OH 43614
Phone (419) 383-3556

4235 Secor Rd
Toledo, OH 43623
Phone (419) 214-4214

2109 Hughes Dr
Ste 450
Toledo, OH 43606
Phone (419) 251-3112

Interoperability endpoints

  • Direct secure messaging: sforshey222353@direct.promedica.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1614211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635811200000",
    "number": "1063006435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4510 DORR ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436154040",
            "telephone_number": "419-383-5334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 HOSPITAL DR",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436148001",
            "telephone_number": "419-383-3761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORSHEY",
        "first_name": "SAMUEL",
        "middle_name": "D",
        "credential": "MSN, FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-25",
        "last_updated": "2021-11-02",
        "certification_date": "2021-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "F08201188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.