Individual provider Active NPI

Anna L Nelson, MD

  • Family Medicine Physician
  • Perrysburg, OH
National Provider Identifier
1114219516
Registry record updated Mar 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35-122352 Issued in OH
Practice address
7045 Lighthouse Way
Perrysburg, OH 43551-7000
Phone
(419) 873-6836
Fax
(419) 873-6837
NPI assigned
May 4, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 35-122352 OH Primary

Addresses

Primary practice location

7045 Lighthouse Way
Perrysburg, OH 43551-7000

Mailing address

7045 Lighthouse Way
Perrysburg, OH 43551-7000
Phone (419) 873-6836

Other practice location 1

2100 W Central Ave
#200
Toledo, OH 43606-3800
Phone (419) 291-2051

Other identifiers 1

IdentifierTypeStateIssuer
104905MedicaidOH

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140723001971 OH Practitioner - Family Practice 8921246349 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Physicians-North LLCGroup PAC ID 2668522400, 131 clinicians

Practice addresses (Care Compare)

2213 Cherry St
Toledo, OH 43608-2603

2222 Cherry St
Toledo, OH 43608-2675

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35-122352OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians-North LLC Family Medicine CurrentSince Jun 1, 2023 Accepting new patients
Mercy Health Physicians - North, LLC CurrentSince Jun 1, 2023 Accepting new patients
Mercy Health System Northern Past Accepting new patients
Mercy Health - St Vincent Medical Center LLC Past Accepting new patients

Locations

5901 Monclova Rd
Maumee, OH 43537
Phone (419) 893-5911

7045 Lighthouse Way
Perrysburg, OH 43551
Phone (419) 794-9292

2222 Cherry St
Ste 2300
Toledo, OH 43608
Phone (419) 251-8013

Organizations & group practices 4

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 3

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": "1304467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585612800000",
    "number": "1114219516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7045 LIGHTHOUSE WAY",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435517000",
            "telephone_number": "419-873-6836",
            "fax_number": "419-873-6837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7045 LIGHTHOUSE WAY",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435517000",
            "telephone_number": "419-873-6836",
            "fax_number": "419-873-6837"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2100 W Central Ave",
            "address_2": "#200",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436063800",
            "country_code": "US",
            "telephone_number": "419-291-2051",
            "fax_number": "419-291-4558",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "ANNA",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-04",
        "last_updated": "2020-03-31",
        "certification_date": "2020-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35-122352",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104905",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Perrysburg, OH

Sources for this page

Verify at the official NPI Registry.