NPIMap

Organization Active NPI

Defiance Regional Medical Center

Doing business as defiance Regional Psychiatric Service

  • Clinical Social Worker
  • Defiance, OH
National Provider Identifier
1083713770
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I0004427 Issued in OH
Legal business name
DEFIANCE REGIONAL MEDICAL CENTER
Doing business as
defiance Regional Psychiatric Service
Practice address
1250 Ralston Ave
Suite 105
Defiance, OH 43512-5311
Phone
(419) 783-6805
Fax
(419) 783-6804
NPI assigned
Sep 21, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Jeanne M Peffley
Title
Office Manager
Phone
(419) 783-6805

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I0004427 OH Primary

Addresses

Primary practice location

1250 Ralston Ave
Suite 105
Defiance, OH 43512-5311

Mailing address

1250 Ralston Ave
Suite 105
Defiance, OH 43512-5311
Phone (419) 783-6805

Other names 1

  • defiance Regional Psychiatric Service Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Defiance Reg Med Ctr Ra14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

Locations

1250 Ralston Ave
Ste 105
Defiance, OH 43512
Phone (419) 783-6805

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083713770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 RALSTON AVE",
            "address_2": "SUITE 105",
            "city": "DEFIANCE",
            "state": "OH",
            "postal_code": "435125311",
            "telephone_number": "419-783-6805",
            "fax_number": "419-783-6804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 RALSTON AVE",
            "address_2": "SUITE 105",
            "city": "DEFIANCE",
            "state": "OH",
            "postal_code": "435125311",
            "telephone_number": "419-783-6805",
            "fax_number": "419-783-6804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEFIANCE REGIONAL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PEFFLEY",
        "authorized_official_first_name": "JEANNE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "419-783-6805",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I0004427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "defiance Regional Psychiatric Service",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Defiance, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.