NPIMap

Organization Active NPI

Promedica Central Physician, LLC

Doing business as ProMedica Physicians Adult Medicine Clinic

  • Internal Medicine Physician
  • Toledo, OH
National Provider Identifier
1346587276
Registry record updated Jan 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
PROMEDICA CENTRAL PHYSICIAN, LLC
Doing business as
ProMedica Physicians Adult Medicine Clinic
Practice address
2150 W Central Ave
Toledo, OH 43606-3834
Phone
(419) 291-3300
Fax
(419) 479-3298
NPI assigned
Jan 11, 2013
Last updated
Jan 11, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2013

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

Authorized official

Name
Lorraine McCune
Title
Credentialing Corrdinator
Phone
(419) 824-7264

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

2150 W Central Ave
Toledo, OH 43606-3834

Mailing address

2150 W Central Ave
Toledo, OH 43606-3834
Phone (419) 291-3300

Other names 1

  • ProMedica Physicians Adult Medicine Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Promedica Central Physi75 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1357862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357862400000",
    "number": "1346587276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2150 W CENTRAL AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436063834",
            "telephone_number": "419-291-3300",
            "fax_number": "419-479-3298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 W CENTRAL AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436063834",
            "telephone_number": "419-291-3300",
            "fax_number": "419-479-3298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROMEDICA CENTRAL PHYSICIAN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-11",
        "last_updated": "2013-01-11",
        "status": "A",
        "authorized_official_last_name": "MCCUNE",
        "authorized_official_first_name": "LORRAINE",
        "authorized_official_title_or_position": "CREDENTIALING CORRDINATOR",
        "authorized_official_telephone_number": "419-824-7264"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ProMedica Physicians Adult Medicine Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 11, 2013; 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.