NPIMap

Organization Active NPI

University of Toledo Physicians, LLC

  • Sports Medicine (Family Medicine) Physician
  • Toledo, OH
National Provider Identifier
1215240676
Registry record updated Jun 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
Legal business name
UNIVERSITY OF TOLEDO PHYSICIANS, LLC
Practice address
3000 Arlington Ave
Toledo, OH 43614-2595
Phone
(419) 383-3761
Fax
(419) 383-6170
NPI assigned
Jul 14, 2010
Last updated
Jun 14, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
UNIVERSITY OF TOLEDO PHYSICIANS CLINICAL FACULTYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 14, 2019

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

Authorized official

Name
Dr. Kris Brickman, MD
Title
Utp President
Phone
(419) 383-7100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X Primary

Addresses

Primary practice location

3000 Arlington Ave
Toledo, OH 43614-2595

Mailing address

3355 Glendale Ave
Third Floor
Toledo, OH 43614-2426
Phone (419) 383-7100

Other identifiers 1

IdentifierTypeStateIssuer
0329226MedicaidOH

Other names 1

  • UTP Sports Medicine Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031205000019 OH Part B Supplier - Clinic/Group Practice 8729983416 Receives reassigned benefits from 583 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Toledo, OH; Wauseon, OH; Upper Sandusky, OH; Waterville, OH; Bowling Green, OH; Bellevue, OH; Bryan, OH; Lima, OH…

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

3355 Glendale Ave
Toledo, OH 43614
Phone (419) 383-5614

3355 Glendale Ave
Fl Third
Toledo, OH 43614

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9641/brand/2/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 91

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 91

NPI Registry JSON

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

{
    "created_epoch": "1279065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560470400000",
    "number": "1215240676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3355 GLENDALE AVE",
            "address_2": "THIRD FLOOR",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436142426",
            "telephone_number": "419-383-7100",
            "fax_number": "419-383-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 ARLINGTON AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436142595",
            "telephone_number": "419-383-3761",
            "fax_number": "419-383-6170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF TOLEDO PHYSICIANS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNIVERSITY OF TOLEDO PHYSICIANS CLINICAL FACULTY",
        "enumeration_date": "2010-07-14",
        "last_updated": "2019-06-14",
        "status": "A",
        "authorized_official_last_name": "BRICKMAN",
        "authorized_official_first_name": "KRIS",
        "authorized_official_title_or_position": "UTP PRESIDENT",
        "authorized_official_telephone_number": "419-383-7100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0329226",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UTP Sports Medicine",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "UTP Sports Medicine",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 14, 2019; 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.