NPIMap

Organization Active NPI

A4 of Ohio, LLC

  • Anesthesiology Physician
  • Toledo, OH
National Provider Identifier
1255996567
Registry record updated May 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
A4 OF OHIO, LLC
Practice address
4235 Secor Rd
Toledo, OH 43623-4299
Phone
(419) 473-3561
Fax
(419) 214-1979
NPI assigned
May 2, 2019
Last updated
May 15, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
A4 MANAGEMENT COMPANY, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 15, 2023

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

Authorized official

Name
Traci Coffman, MDNPI 1457399719
Title
Owner
Phone
(734) 263-2400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X NU
Anesthesiologist Assistant 367H00000X NU
Anesthesiology Physician 207L00000X NU Primary

Addresses

Primary practice location

4235 Secor Rd
Toledo, OH 43623-4299

Mailing address

2006 Hogback Rd Ste 5a
Ann Arbor, MI 48105-9750
Phone (734) 263-2400

Other practice location 1

3330 Meijer Dr
Toledo, OH 43617-3103
Phone (419) 578-2020

Other names 1

  • A4 Management Company, LLC Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190621001667 OH Part B Supplier - Clinic/Group Practice 3971837188 Receives reassigned benefits from 47 practitioners
Practice locations: Maumee, OH; Toledo, OH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 49

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 49

NPI Registry JSON

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

{
    "created_epoch": "1556755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684108800000",
    "number": "1255996567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2006 HOGBACK RD STE 5A",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059750",
            "telephone_number": "734-263-2400",
            "fax_number": "734-773-3471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4235 SECOR RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234299",
            "telephone_number": "419-473-3561",
            "fax_number": "419-214-1979"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3330 Meijer Dr",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436173103",
            "country_code": "US",
            "telephone_number": "419-578-2020",
            "fax_number": "419-539-6323",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "A4 OF OHIO, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "A4 MANAGEMENT COMPANY, LLC",
        "enumeration_date": "2019-05-02",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A",
        "authorized_official_last_name": "COFFMAN",
        "authorized_official_first_name": "TRACI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "734-263-2400",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "A4 Management Company, LLC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "A4 Management Company, LLC",
            "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 May 15, 2023; 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.