NPIMap

Organization Active NPI

Promedica Centrsl Physicians, LLC

  • Internal Medicine Physician
  • Toledo, OH
National Provider Identifier
1174667299
Registry record updated Nov 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
PROMEDICA CENTRSL PHYSICIANS, LLC
Practice address
3909 Woodley Rd
Suite 600
Toledo, OH 43606-1169
Phone
(419) 291-6760
Fax
(419) 472-4359
NPI assigned
Feb 20, 2007
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Kenya Dixon
Title
Credentialing Assistant
Phone
(419) 824-7288

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

View all 24

National Provider Directory

National Provider Directory
Tax ID family
Promedica Central Physi (75 organizations share this tax ID)

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

3909 Woodley Rd
Suite 600
Toledo, OH 43606-1169

Mailing address

3909 Woodley Rd
Suite 600
Toledo, OH 43606-1169
Phone (419) 291-6760

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
4036950008OtherOHDMERC

Other names 1

NPPES NPI Registry
  • West Central Medical Group Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 29, 2007.

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196294400000",
    "number": "1174667299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3909 WOODLEY RD",
            "address_2": "SUITE 600",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436061169",
            "telephone_number": "419-291-6760",
            "fax_number": "419-472-4359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3909 WOODLEY RD",
            "address_2": "SUITE 600",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436061169",
            "telephone_number": "419-291-6760",
            "fax_number": "419-472-4359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROMEDICA CENTRSL PHYSICIANS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2007-11-29",
        "status": "A",
        "authorized_official_last_name": "DIXON",
        "authorized_official_first_name": "KENYA",
        "authorized_official_title_or_position": "CREDENTIALING ASSISTANT",
        "authorized_official_telephone_number": "419-824-7288"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "4036950008",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Central Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 29, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.