Organization Active NPI

Sylvan Oak Family Physicians LLC

  • Family Medicine Physician
  • Toledo, OH
National Provider Identifier
1104971290
Registry record updated Feb 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SYLVAN OAK FAMILY PHYSICIANS LLC
Practice address
6800 W Central Ave
Unit K
Toledo, OH 43617-1135
Phone
(417) 841-1510
Fax
(419) 841-1513
NPI assigned
Jan 25, 2007
Last updated
Feb 6, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2009

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

Authorized official

Name
Dr. Mark A Wentz, MDNPI 1336116326
Title
Managing Partner
Phone
(419) 841-1510

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

6800 W Central Ave
Unit K
Toledo, OH 43617-1135

Mailing address

6800 W Central Ave
Unit K
Toledo, OH 43617-1135
Phone (417) 841-1510

Other identifiers 3

IdentifierTypeStateIssuer
000000343375OtherOHANTHEM
DC0339OtherOHRAILROAD MEDICARE
2595302MedicaidOH

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D0948463Sylvan Oak Family Physicians DRS D Fairchild,6800 W Central Avenue Unit K, Toledo, OH 43617Provider-performed microscopyJul 9, 2028

National Provider Directory

National Provider Directory

Locations

6800 W Central Ave
Unit K
Toledo, OH 43617
Phone (419) 841-1510

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233878400000",
    "number": "1104971290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6800 W CENTRAL AVE",
            "address_2": "UNIT K",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436171135",
            "telephone_number": "417-841-1510",
            "fax_number": "419-841-1513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6800 W CENTRAL AVE",
            "address_2": "UNIT K",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436171135",
            "telephone_number": "417-841-1510",
            "fax_number": "419-841-1513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYLVAN OAK FAMILY PHYSICIANS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2009-02-06",
        "status": "A",
        "authorized_official_last_name": "WENTZ",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "419-841-1510",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000343375",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DC0339",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2595302",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.