Promedica Central Physicians, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PROMEDICA CENTRAL PHYSICIANS, LLC

Doing business as

River Road Family Physicians

Practice address

1601 Brigham Dr
Suite 250
Perrysburg, OH 43551-7114

Phone

(419) 872-5865

Fax

(419) 874-7758

NPI assigned

Feb 9, 2007

Last updated

Feb 18, 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

Kenya Dixon

Title

Credentialing Assistant

Phone

(419) 824-7288

Specialties & licenses 1

Addresses

Other names 1

• River Road Family Physicians Doing business as

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

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203292800000",
    "number": "1376684688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 BRIGHAM DR",
            "address_2": "SUITE 250",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435517114",
            "telephone_number": "419-872-5865",
            "fax_number": "419-874-7758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 BRIGHAM DR",
            "address_2": "SUITE 250",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435517114",
            "telephone_number": "419-872-5865",
            "fax_number": "419-874-7758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROMEDICA CENTRAL PHYSICIANS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-09",
        "last_updated": "2008-02-18",
        "status": "A",
        "authorized_official_last_name": "DIXON",
        "authorized_official_first_name": "KENYA",
        "authorized_official_title_or_position": "CREDENTIALING ASSISTANT",
        "authorized_official_telephone_number": "419-824-7288"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "River Road Family Physicians",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Emilee Puchta

• Family Medicine Physician in Perrysburg, OH
• Providers in Perrysburg, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.