NPIMap

Organization Active NPI

Promedica Central Physicians, LLC

  • Obstetrics & Gynecology Physician
  • Sylvania, OH
National Provider Identifier
1255475372
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
PROMEDICA CENTRAL PHYSICIANS, LLC
Practice address
5300 Harroun Rd
Suite 226
Sylvania, OH 43560-2182
Phone
(419) 824-5640
Fax
(419) 824-5744
NPI assigned
Feb 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

5300 Harroun Rd
Suite 226
Sylvania, OH 43560-2182

Mailing address

5300 Harroun Rd
Suite 226
Sylvania, OH 43560-2182
Phone (419) 824-5640

Other names 1

  • Sarah Puckett, DO Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Promedica Central Physi75 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

5300 Harroun Rd
Ste 226
Sylvania, OH 43560
Phone (419) 824-5640

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1255475372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 HARROUN RD",
            "address_2": "SUITE 226",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435602182",
            "telephone_number": "419-824-5640",
            "fax_number": "419-824-5744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 HARROUN RD",
            "address_2": "SUITE 226",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435602182",
            "telephone_number": "419-824-5640",
            "fax_number": "419-824-5744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROMEDICA CENTRAL PHYSICIANS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2020-08-22",
        "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": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sarah Puckett, DO",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sylvania, OH

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.