Rossford Family Practice

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

ROSSFORD FAMILY PRACTICE

Practice address

930 Dixie Hwy
Rossford, OH 43460-1333

Phone

(419) 666-0253

Fax

(419) 666-4340

NPI assigned

Dec 19, 2005

Organization subpart

No

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

Authorized official

Name

Sue Pacer

Title

Office Manager

Phone

(419) 666-0253

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1134950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194701409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 DIXIE HWY",
            "city": "ROSSFORD",
            "state": "OH",
            "postal_code": "434601333",
            "telephone_number": "419-666-0253",
            "fax_number": "419-666-4340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 DIXIE HWY",
            "city": "ROSSFORD",
            "state": "OH",
            "postal_code": "434601333",
            "telephone_number": "419-666-0253",
            "fax_number": "419-666-4340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSSFORD FAMILY PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PACER",
        "authorized_official_first_name": "SUE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "419-666-0253"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2174598",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karina Wehking Revnak
• Jessie Riley
• Rite Aid of Ohio Inc
• Destiny Roberson
• Nicole Anne Roe
• Sean Royer, PHARMD
• Javon Ruffin
• Brianna H Sahibdeen
• Nicole Rose Sample
• Macanthony Romuke Samu

• Family Medicine Physician in Rossford, OH
• Providers in Rossford, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.