Active NPI
Roy Wayne Wolfram, MD
- Emergency Medicine Physician
- Toledo, OH
National Provider Identifier
1306809231
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 35075616
- Practice address
- 2213 Cherry St
Toledo, OH 43608-2603 - Phone
- (419) 251-3232
- NPI assigned
- Apr 11, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 35075616 | OH | Primary |
Addresses
Primary practice location
2213 Cherry St
Toledo, OH 43608-2603
Mailing address
4750 Hempstead Station Dr
Kettering, OH 45429-5164
Phone (800) 875-0136
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 104818446 | Other | MICHIGAN MEDICAID | |
| 104824480 | Medicaid | MI | |
| 2242675 | Medicaid | OH | |
| 000000380633 | Other | OH | IND BC/BS # ST. V-ER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35075616 | OH | MD | Emergency Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144713600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213142400000",
"number": "1306809231",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4750 HEMPSTEAD STATION DR",
"city": "KETTERING",
"state": "OH",
"postal_code": "454295164",
"telephone_number": "800-875-0136",
"fax_number": "937-619-4231"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2213 CHERRY ST",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436082603",
"telephone_number": "419-251-3232"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOLFRAM",
"first_name": "ROY",
"middle_name": "WAYNE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-11",
"last_updated": "2008-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "OH",
"license": "35075616",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MICHIGAN MEDICAID",
"identifier": "104818446",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "104824480",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2242675",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IND BC/BS # ST. V-ER",
"identifier": "000000380633",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
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 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.