NPIMap

Organization Active NPI

Promedica Central Physicians

  • Family Medicine Physician
  • Toledo, OH
National Provider Identifier
1396603148
Registry record updated Jan 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PROMEDICA CENTRAL PHYSICIANS
Practice address
1 Owens Corning Pkwy # B-2
Toledo, OH 43659-1000
Phone
(567) 585-0060
Fax
(567) 455-5902
NPI assigned
Jan 12, 2026
Last updated
Jan 12, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2026

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

Authorized official

Name
Tanya Wines
Title
Director, System Credentialing
Phone
(567) 585-0422

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

1 Owens Corning Pkwy # B-2
Toledo, OH 43659-1000

Mailing address

100 Madison Ave FL 3
Toledo, OH 43604-1516

Other practice location 1

380 John St
Newark, OH 43055-5852
Phone (740) 281-2594

Other practice location 2

2790 Columbus Rd
Granville, OH 43023-1252
Phone (740) 281-2576

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
36D2140250Promedica Physicians at380 John Street, Newark, OH 43055Certificate of waiverNov 15, 2027

National Provider Directory

National Provider Directory
Tax ID family
Promedica Central Physicians LLC75 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

Locations

2790 Columbus Rd
Granville, OH 43023
Phone (740) 281-2576

1 Owens Corning Pkwy
#B2
Toledo, OH 43659
Phone (567) 585-0060

Practitioners & affiliated clinicians

Practitioners 4

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": "1768176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768176000000",
    "number": "1396603148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MADISON AVE FL 3",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436041516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 OWENS CORNING PKWY # B-2",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436591000",
            "telephone_number": "567-585-0060",
            "fax_number": "567-455-5902"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "380 John St",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "OH",
            "postal_code": "430555852",
            "country_code": "US",
            "telephone_number": "740-281-2594",
            "fax_number": "740-281-2699",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2790 Columbus Rd",
            "address_purpose": "LOCATION",
            "city": "Granville",
            "state": "OH",
            "postal_code": "430231252",
            "country_code": "US",
            "telephone_number": "740-281-2576",
            "fax_number": "740-281-2575",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PROMEDICA CENTRAL PHYSICIANS",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-12",
        "last_updated": "2026-01-12",
        "certification_date": "2026-01-12",
        "status": "A",
        "authorized_official_last_name": "WINES",
        "authorized_official_first_name": "TANYA",
        "authorized_official_title_or_position": "DIRECTOR, SYSTEM CREDENTIALING",
        "authorized_official_telephone_number": "567-585-0422"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 12, 2026; 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.