Individual provider Active NPI

Kristin Manon, NP-C

  • Nurse Practitioner
  • Toledo, OH
National Provider Identifier
1073914305
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN.CNP.16485 Issued in OH
Practice address
3404 W Sylvania Ave
Toledo, OH 43623-4467
Phone
(419) 407-1444
NPI assigned
Sep 5, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.16485 OH
Nurse Practitioner 363L00000X APRN.CNP.16485 OH Primary
Nurse Practitioner 363L00000X RN.344353 OH

Addresses

Primary practice location

3404 W Sylvania Ave
Toledo, OH 43623-4467

Mailing address

3404 W Sylvania Ave
Toledo, OH 43623-4467

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
I20141106001408 OH Practitioner - Nurse Practitioner 0648492652 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverwood Emergency Services IncGroup PAC ID 1153225669, 34 clinicians
Emergency Professional Services, Inc.Group PAC ID 7214832435, 121 clinicians

Practice addresses (Care Compare)

12621 Eckel Junction Rd
Perrysburg, OH 43551-1304
Phone (567) 368-1008

1400 W Main St
Bellevue, OH 44811-9088
Phone (419) 483-4040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN.344353OHMDNurse Practitioner
APRN.CNP.16485OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Emergency Care Services, Inc. Nurse Practitioner CurrentSince May 1, 2017 Accepting new patients
Emergency Professional Services, Inc. Nurse Practitioner CurrentSince Apr 1, 2022 Accepting new patients

Locations

1400 W Main St
Bellevue, OH 44811
Phone (330) 563-0641

18697 Bagley Rd
Middleburg Heights, OH 44130
Phone (440) 816-8000

2600 Navarre Ave
Oregon, OH 43616
Phone (419) 696-7200

3404 W Sylvania Ave
Toledo, OH 43623
Phone (419) 407-1422

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.

NPI Registry JSON

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

{
    "created_epoch": "1409875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1073914305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3404 W SYLVANIA AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3404 W SYLVANIA AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234467",
            "telephone_number": "419-407-1444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANON",
        "first_name": "KRISTIN",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-05",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.16485",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "APRN.CNP.16485",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "RN.344353",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.