NPIMap

Organization Active NPI

Promedica Monroe Physicians

  • Family Medicine Physician
  • Toledo, OH
National Provider Identifier
1194078055
Registry record updated Jun 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PROMEDICA MONROE PHYSICIANS
Practice address
100 Madison Ave
MSC-S38805
Toledo, OH 43604
Phone
(844) 373-0871
Fax
(419) 885-3921
NPI assigned
Oct 17, 2012
Last updated
Jun 23, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2026

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

Authorized official

Name
Kevin Sharp
Title
Vice President Revenue Cycle
Phone
(567) 585-7576

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X MI Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X MI
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X MI
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X MI
Hospitalist PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208M00000X MI

Addresses

Primary practice location

100 Madison Ave
MSC-S38805
Toledo, OH 43604

Mailing address

100 Madison Ave
Toledo, OH 43604-1516
Phone (844) 373-0871

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20130201000483 MI Part B Supplier - Clinic/Group Practice 2365696176 Receives reassigned benefits from 86 practitioners
Practice locations: Newport, MI; Monroe, MI; Carleton, MI; Dundee, MI; Luna Pier, MI; Lambertville, MI
O20180724004047 OH Part B Supplier - Clinic/Group Practice 2365696176 Receives reassigned benefits from 4 practitioners
Practice locations: Toledo, OH

National Provider Directory

National Provider Directory

Locations

111 Medical Center Dr
Carleton, MI 48117
Phone (734) 240-8580

130 Medical Center Dr
Carleton, MI 48117

100 Powell Dr
Ste 2
Dundee, MI 48131
Phone (734) 240-4290

1086 N Monroe St
Monroe, MI 48162
Phone (734) 244-5380

419 S Telegraph Rd
Monroe, MI 48161
Phone (734) 241-1100

730 N Macomb St
Ste 229
Monroe, MI 48162
Phone (313) 243-4220

905 N Macomb St
Monroe, MI 48162
Phone (734) 240-4851

7825 N Dixie Hwy
#101
Newport, MI 48166
Phone (734) 240-4580

5200 Harroun Rd
Fl 1
Sylvania, OH 43560

5700 Monroe St
Unit 309
Sylvania, OH 43560
Phone (419) 291-2090

2901 N Reynolds Rd
Toledo, OH 43615
Phone (419) 578-7107

Practitioners & affiliated clinicians

Practitioners 92

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 92

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1350432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782172800000",
    "number": "1194078055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MADISON AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436041516",
            "telephone_number": "844-373-0871",
            "fax_number": "419-885-3921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MADISON AVE",
            "address_2": "MSC-S38805",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "43604",
            "telephone_number": "844-373-0871",
            "fax_number": "419-885-3921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROMEDICA MONROE PHYSICIANS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-17",
        "last_updated": "2026-06-23",
        "certification_date": "2026-06-23",
        "status": "A",
        "authorized_official_last_name": "SHARP",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "VICE PRESIDENT REVENUE CYCLE",
        "authorized_official_telephone_number": "567-585-7576"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": "MI",
            "license": null,
            "primary": false
        }
    ],
    "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 Jun 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.