Community Hospitals and Wellness Centers Internal Medicine Clinic

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

COMMUNITY HOSPITALS AND WELLNESS CENTERS INTERNAL MEDICINE CLINIC

Practice address

447 N Shoop Ave
Wauseon, OH 43567-1261

Phone

(419) 337-7980

Fax

(419) 337-8265

NPI assigned

Mar 2, 2007

Last updated

Feb 4, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Philip L. Ennen

Title

President

Phone

(419) 636-1131

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

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

• Community Hospitals and Wellness Centers

  • General Practice Physician
  • Bryan, OH
  • NPI 1225167893

  O20040226001067

  Same enrollment

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202083200000",
    "number": "1376671065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "447 N SHOOP AVE",
            "city": "WAUSEON",
            "state": "OH",
            "postal_code": "435671261",
            "telephone_number": "419-337-7980",
            "fax_number": "419-337-8265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "447 N SHOOP AVE",
            "city": "WAUSEON",
            "state": "OH",
            "postal_code": "435671261",
            "telephone_number": "419-337-7980",
            "fax_number": "419-337-8265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HOSPITALS AND WELLNESS CENTERS INTERNAL MEDICINE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-02",
        "last_updated": "2008-02-04",
        "status": "A",
        "authorized_official_last_name": "ENNEN",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "419-636-1131",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• City of Wauseon (Wauseon Fire Department)
• Anne Clark, LPCC
• Leslie S Clemensen, MD
• Kimberly Sue Clingaman, QMHS
• Kelly Cohoon
• Priscilla Conti
• Tasha Cook
• Gregory S. Cousino, D.D.S.
• Stephen Andrew Cox, MD
• Jill Crossgrove-Murillo, RD

• Internal Medicine Physician in Wauseon, OH
• Providers in Wauseon, OH by specialty
• Internal Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2008; 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.