NPIMap

Organization Active NPI

Go Tyme Grynd LLC

  • Community/Behavioral Health Agency
  • Toledo, OH
National Provider Identifier
1336910587
Registry record updated Jan 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
GO TYME GRYND LLC
Practice address
3403 Monroe St
Toledo, OH 43606-4140
Phone
(419) 509-0509
NPI assigned
Jan 15, 2024
Last updated
Jan 15, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2024

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

Authorized official

Name
Deandre GastonNPI 1992576151
Title
Owner
Phone
(419) 709-0509

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

3403 Monroe St
Toledo, OH 43606-4140

Mailing address

1836 Dorr St
Toledo, OH 43607-3701
Phone (419) 702-0509

National Provider Directory

National Provider Directory

Locations

1836 Dorr St
Toledo, OH 43607

3403 Monroe St
Toledo, OH 43606
Phone (419) 509-0509

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1705276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705276800000",
    "number": "1336910587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1836 DORR ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436073701",
            "telephone_number": "419-702-0509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3403 MONROE ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436064140",
            "telephone_number": "419-509-0509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GO TYME GRYND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-15",
        "last_updated": "2024-01-15",
        "certification_date": "2024-01-15",
        "status": "A",
        "authorized_official_last_name": "GASTON",
        "authorized_official_first_name": "DEANDRE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "419-709-0509"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jan 15, 2024; 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.