Active NPI
Mark D Hillard, M.D.
- Family Medicine Physician
- Toledo, OH
National Provider Identifier
1124024492
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 35049105H
- Practice address
- 4041 W Sylvania Ave
Ste 100
Toledo, OH 43623-4465 - Phone
- (419) 472-1124
- Fax
- (419) 486-8857
- NPI assigned
- Jun 22, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 35049105H | OH | Primary |
Addresses
Primary practice location
4041 W Sylvania Ave
Ste 100
Toledo, OH 43623-4465
Mailing address
2200 Jefferson Ave
4TH Floor
Toledo, OH 43604-7101
Phone (419) 251-1963
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 35049105 | Other | OH | OH MEDICAL LICENSE |
| 080166338 | Other | OH | RAILROAD MEDICARE |
| 0826100 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35049105H | OH | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1392854400000",
"number": "1124024492",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2200 JEFFERSON AVE",
"address_2": "4TH FLOOR",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436047101",
"telephone_number": "419-251-1963",
"fax_number": "419-486-8857"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4041 W SYLVANIA AVE",
"address_2": "STE 100",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436234465",
"telephone_number": "419-472-1124",
"fax_number": "419-486-8857"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HILLARD",
"first_name": "MARK",
"middle_name": "D",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-22",
"last_updated": "2014-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OH",
"license": "35049105H",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OH MEDICAL LICENSE",
"identifier": "35049105",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "080166338",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0826100",
"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 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.