NPIMap

Organization Active NPI

Lima Memorial Professional Corporation

  • Family Medicine Physician
  • Lima, OH
National Provider Identifier
1295046480
Registry record updated Apr 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LIMA MEMORIAL PROFESSIONAL CORPORATION
Practice address
1005 Bellefontaine Ave Ste 100
Lima, OH 45804-2871
Phone
(419) 227-5298
Fax
(419) 227-5879
NPI assigned
Jun 23, 2010
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Jeffrey Utz
Title
Director of LMP
Phone
(419) 998-4668

Other NPIs on the same Medicare enrollment 11

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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040115000131 OH Part B Supplier - Clinic/Group Practice 1254232184 Receives reassigned benefits from 265 practitioners
19 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lima, OH; Novelty, OH; Ottawa, OH; Ottawa Hills, OH; Russells Point, OH; Sidney, OH; Solon, OH; Van Wert, OH…

National Provider Directory

National Provider Directory

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

1005 Bellefontaine Ave Ste 100
Lima, OH 45804-2871

Mailing address

1001 Bellefontaine Ave
Lima, OH 45804-2800
Phone (419) 998-4575

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
1457474900OtherOHGROUP NPI
2223703MedicaidOH

Other names 2

NPPES NPI Registry
  • Lima Family Care Doing business as
  • Lima Memorial Health System Family Care Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 9, 2022.

{
    "created_epoch": "1277251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649462400000",
    "number": "1295046480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 BELLEFONTAINE AVE",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458042800",
            "telephone_number": "419-998-4575",
            "fax_number": "419-998-4586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 BELLEFONTAINE AVE STE 100",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458042871",
            "telephone_number": "419-227-5298",
            "fax_number": "419-227-5879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIMA MEMORIAL PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-23",
        "last_updated": "2022-04-09",
        "certification_date": "2022-04-09",
        "status": "A",
        "authorized_official_last_name": "UTZ",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "DIRECTOR OF LMP",
        "authorized_official_telephone_number": "419-998-4668"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1457474900",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2223703",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lima Family Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lima Memorial Health System Family Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lima, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2022; 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.