NPIMap

Organization Active NPI

Terrence L Johnson & Robert C Adams PTR

Doing business as Van Wert Family Physicians

  • Family Medicine Physician
  • Van Wert, OH
National Provider Identifier
1356481584
Registry record updated Apr 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
TERRENCE L JOHNSON & ROBERT C ADAMS PTR
Doing business as
Van Wert Family Physicians
Practice address
1178 Professional Dr
Van Wert, OH 45891-2461
Phone
(419) 238-6251
Fax
(419) 238-3002
NPI assigned
Feb 7, 2007
Last updated
Apr 5, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2021

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

Authorized official

Name
Ms. Kelly Kay Sutton
Title
Office Manager
Phone
(419) 238-6251

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OH Primary

Addresses

Primary practice location

1178 Professional Dr
Van Wert, OH 45891-2461

Mailing address

1178 Professional Dr
Van Wert, OH 45891-2461
Phone (419) 238-6251

Other identifiers 2

IdentifierTypeStateIssuer
DA5391OtherOHRR MEDICARE
0506929MedicaidOH

Other names 1

  • VAN WERT FAMILY PHYSICIANS Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031229000946 OH Part B Supplier - Clinic/Group Practice 1850299868 Receives reassigned benefits from 8 practitioners
Practice locations: Van Wert, OH

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D0351906Terrence L Johnson & Robert C Adams1178 Professional Dr, Van Wert, OH 45891Provider-performed microscopyMar 30, 2027

National Provider Directory

National Provider Directory

Locations

1178 Professional Dr
Van Wert, OH 45891
Phone (419) 238-6251

Interoperability endpoints

  • Direct secure messaging: adamhoug@vanwfamphy.allscriptsdirect.net
  • Direct secure messaging: courtneylinton@vanwfamphy.allscriptsdirect.net
  • Direct secure messaging: elizabethadams@vanwfamphy.allscriptsdirect.net
  • Direct secure messaging: jacobjones@vanwfamphy.allscriptsdirect.net
  • Direct secure messaging: juliemoenter@vanwfamphy.allscriptsdirect.net
  • Direct secure messaging: kristenpollock@vanwfamphy.allscriptsdirect.net
  • Direct secure messaging: melisakeuneke@vanwfamphy.allscriptsdirect.net
  • Direct secure messaging: rebeccaadams@vanwfamphy.allscriptsdirect.net
  • Direct secure messaging: robertadams@vanwfamphy.allscriptsdirect.net

Practitioners & affiliated clinicians

Practitioners 8

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": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617580800000",
    "number": "1356481584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1178 PROFESSIONAL DR",
            "city": "VAN WERT",
            "state": "OH",
            "postal_code": "458912461",
            "telephone_number": "419-238-6251",
            "fax_number": "419-238-3002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1178 PROFESSIONAL DR",
            "city": "VAN WERT",
            "state": "OH",
            "postal_code": "458912461",
            "telephone_number": "419-238-6251",
            "fax_number": "419-238-3002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TERRENCE L JOHNSON & ROBERT C ADAMS PTR",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2021-04-05",
        "certification_date": "2021-04-05",
        "status": "A",
        "authorized_official_last_name": "SUTTON",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "419-238-6251",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "DA5391",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0506929",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VAN WERT FAMILY PHYSICIANS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "VAN WERT FAMILY PHYSICIANS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Van Wert, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.