NPIMap

Organization Active NPI

Mercy Health - Willard Hospital LLC

  • Cardiovascular Disease Physician
  • Willard, OH
National Provider Identifier
1265605240
Registry record updated Sep 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
MERCY HEALTH - WILLARD HOSPITAL LLC
Practice address
110 E Howard St
Willard, OH 44890-1611
Phone
(419) 964-5000
NPI assigned
Apr 10, 2008
Last updated
Sep 2, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2014

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

Authorized official

Name
Mr. Brian D Smith
Title
Evp
Phone
(419) 226-9117

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X Primary

Addresses

Primary practice location

110 E Howard St
Willard, OH 44890-1611

Mailing address

2200 Jefferson Ave
4TH Floor
Toledo, OH 43604-7101
Phone (419) 251-8997

Other identifiers 1

IdentifierTypeStateIssuer
2692368MedicaidOH

Other names 1

  • Sister of Mercy of Willard, Ohio Former legal business name

National Provider Directory

National Provider Directory

Locations

1510 S Conwell Ave
Willard, OH 44890
Phone (419) 935-0382

390 E Howard St
Ste B
Willard, OH 44890
Phone (419) 933-4255

Practitioners & affiliated clinicians

Practitioners 23

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 23

NPI Registry JSON

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

{
    "created_epoch": "1207785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409616000000",
    "number": "1265605240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 JEFFERSON AVE",
            "address_2": "4TH FLOOR",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436047101",
            "telephone_number": "419-251-8997",
            "fax_number": "419-251-3553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E HOWARD ST",
            "city": "WILLARD",
            "state": "OH",
            "postal_code": "448901611",
            "telephone_number": "419-964-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY HEALTH - WILLARD HOSPITAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-10",
        "last_updated": "2014-09-02",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "EVP",
        "authorized_official_telephone_number": "419-226-9117",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2692368",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sister of Mercy of Willard, Ohio",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Willard, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2014; 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.