Active NPI
Christle Rose Peter, ODE IS K-12
- Specialist
- Toledo, OH
National Provider Identifier
1124662069
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- OH3114193
- Practice address
- 3450 W Central Ave Ste 126
Toledo, OH 43606-1421 - Phone
- (419) 531-2408
- NPI assigned
- Nov 4, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Specialist | 174400000X | OH3114193 | OH | Primary |
Addresses
Primary practice location
3450 W Central Ave Ste 126
Toledo, OH 43606-1421
Mailing address
10521 Wayne Rd
Wayne, OH 43466-9762
Phone (419) 806-1558
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OH3114193 | OH | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1572825600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1572825600000",
"number": "1124662069",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10521 WAYNE RD",
"city": "WAYNE",
"state": "OH",
"postal_code": "434669762",
"telephone_number": "419-806-1558"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3450 W CENTRAL AVE STE 126",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436061421",
"telephone_number": "419-531-2408"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETER",
"first_name": "CHRISTLE",
"middle_name": "ROSE",
"credential": "ODE IS K-12",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-11-04",
"last_updated": "2019-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "OH",
"license": "OH3114193",
"primary": true
}
],
"identifiers": [],
"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 Nov 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.