Active NPI
Primary Care Center Inc
- Family Medicine Physician
- Sylvania, OH
National Provider Identifier
1386733004
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 35041896
- Legal business name
- PRIMARY CARE CENTER INC
- Practice address
- 7640 Sylvania Ave
Suite E
Sylvania, OH 43560-9729 - Phone
- (419) 473-2273
- NPI assigned
- Oct 12, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. James David Diethelm, M.D.
- Title
- Owner
- Phone
- (419) 473-2273
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 35041896 | OH | Primary |
Addresses
Primary practice location
7640 Sylvania Ave
Suite E
Sylvania, OH 43560-9729
Mailing address
7640 Sylvania Ave
Suite E
Sylvania, OH 43560-9729
Phone (419) 473-2273
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CH6078 | Other | OH | RAILROAD MEDICARE |
| 2218451 | Medicaid | OH |
National Provider Directory
National Provider DirectoryLocations
7640 Sylvania Ave
Ste A-2
Sylvania, OH 43560
Phone (419) 473-2273
Practitioners & affiliated clinicians
Practitioners 6
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Physician Assistant
- Sylvania, OH
- NPI 1053538512
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160611200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1195430400000",
"number": "1386733004",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7640 SYLVANIA AVE",
"address_2": "SUITE E",
"city": "SYLVANIA",
"state": "OH",
"postal_code": "435609729",
"telephone_number": "419-473-2273"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7640 SYLVANIA AVE",
"address_2": "SUITE E",
"city": "SYLVANIA",
"state": "OH",
"postal_code": "435609729",
"telephone_number": "419-473-2273"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PRIMARY CARE CENTER INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-12",
"last_updated": "2007-11-19",
"status": "A",
"authorized_official_last_name": "DIETHELM",
"authorized_official_first_name": "JAMES",
"authorized_official_middle_name": "DAVID",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "419-473-2273",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "OH",
"license": "35041896",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "CH6078",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2218451",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sylvania, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.