Individual provider Active NPI

Paula Sprow, NP

  • Nurse Practitioner
  • Defiance, OH
National Provider Identifier
1396720124
Registry record updated Nov 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP-07120 Issued in OH
Practice address
1250 Ralston Ave
Suite 204
Defiance, OH 43512-5311
Phone
(419) 782-8332
Fax
(419) 782-6855
NPI assigned
Dec 14, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NP-07120 OH Primary

Addresses

Primary practice location

1250 Ralston Ave
Suite 204
Defiance, OH 43512-5311

Mailing address

1250 Ralston Ave
Suite 204
Defiance, OH 43512-5311
Phone (419) 782-8332

Other identifiers 2

IdentifierTypeStateIssuer
000000379388OtherOHANTHEM
2441290MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address psprow16477@epicdirect.promedica.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051028000778 OH Practitioner - Nurse Practitioner 3779511159 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Promedica Central PhysiciansGroup PAC ID 2365348190, 785 clinicians

Practice addresses (Care Compare)

1250 Ralston Ave
Defiance, OH 43512-5308

2109 Hughes Dr
Suite 450
Toledo, OH 43606-5102
Phone (419) 291-2003

2901 N Reynolds Rd
Toledo, OH 43606
Phone (419) 578-7700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP-07120OHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Promedica Central Physicians Nurse Practitioner CurrentSince Dec 31, 2015 Accepting new patients
Promedica Central Physicians CurrentSince Dec 31, 2015 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

1250 Ralston Ave
Ste 205
Defiance, OH 43512
Phone (419) 782-5774

1250 Ralston Ave
Ste 204
Defiance, OH 43512
Phone (419) 782-8332

1250 Ralston Ave
Ste 104
Defiance, OH 43512
Phone (419) 784-3044

100 Madison Ave
Toledo, OH 43604
Phone (567) 585-1964

2109 Hughes Dr
Ste 450
Toledo, OH 43606
Phone (419) 251-3112

Interoperability endpoints

  • Direct secure messaging: psprow16477@direct.promedica.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1396720124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 RALSTON AVE",
            "address_2": "SUITE 204",
            "city": "DEFIANCE",
            "state": "OH",
            "postal_code": "435125311",
            "telephone_number": "419-782-8332",
            "fax_number": "419-782-6855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 RALSTON AVE",
            "address_2": "SUITE 204",
            "city": "DEFIANCE",
            "state": "OH",
            "postal_code": "435125311",
            "telephone_number": "419-782-8332",
            "fax_number": "419-782-6855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPROW",
        "first_name": "PAULA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-14",
        "last_updated": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "NP-07120",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000379388",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2441290",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "psprow16477@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Defiance, OH

Sources for this page

Verify at the official NPI Registry.