Northwest Ohio OBGYN LLC
Organization Active NPI Obstetrics & Gynecology Physician · Bluffton, OH
NPI 1154468809 · NPPES record last updated Jan 14, 2009
Key facts
- NPI
- 1154468809
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- Legal business name
- NORTHWEST OHIO OBGYN LLC
- Practice address
- 547 Harmon Rd
Bluffton, OH 45817-1033 - Phone
- (419) 369-4600
- Fax
- (419) 369-4603
- NPI assigned
- Jan 31, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Desrene K Brown, M.D.
- Title
- Presedent Owner
- Phone
- (419) 369-4600
Practitioners 5
-
Desrene K Brown, MD
-
Emily Kurland, NP
-
Erika Marie King, PA-C
-
Nicole Marie Pothast, MSN, CNM
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041103001328 | OH | Part B Supplier - Clinic/Group Practice | 7517929284 |
Receives reassigned benefits from 4 practitioners Practice locations: Bluffton, OH; Ottawa, OH; Findlay, OH |
National Provider Directory
Locations
1717 Medical Blvd
Ste A
Findlay, OH 45840
Phone (419) 420-7500
1740 N Perry St
Ste C
Ottawa, OH 45875
Phone (419) 523-4611
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician |
207V00000X | Yes |
Addresses
Primary practice location
547 Harmon Rd
Bluffton, OH 45817-1033
Mailing address
547 Harmon Road
P.O. Box 129
Bluffton, OH 45817
Phone (419) 369-4600
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2149624 | Medicaid | OH |
Other providers in Bluffton, OH
- Mennonite Memorial Home
- Mennonite Memorial Home
- Mennonite Memorial Home Communities of Ohio
- Breanna Miller
- Lorraine Kathryn Nester
- Northwest Ohio Orthopedics and Sports Medicine, Inc
- Northwest Ohio Rheumatology Inc
- Christian Krause Nygaard
- Ohio CVS Stores, L.L.C.
- Orthopaedic Institute of Ohio
All providers in Bluffton, OH · Obstetrics & Gynecology Physician in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 14, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.