NPIMap

Organization Active NPI

Neighborhood Health Association of Toledo Inc.

Doing business as NHA Senior Care Clinic

  • Federally Qualified Health Center (FQHC)
  • Toledo, OH
National Provider Identifier
1427170679
Registry record updated Feb 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
NEIGHBORHOOD HEALTH ASSOCIATION OF TOLEDO INC.
Doing business as
NHA Senior Care Clinic
Practice address
1 Aurora L Gonzalez Dr
Toledo, OH 43609-2783
Phone
(419) 241-4230
Fax
(419) 241-4231
NPI assigned
Apr 6, 2007
Last updated
Feb 21, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2024

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

Authorized official

Name
Sandra D Miller-Corbett
Title
Ceo
Phone
(419) 720-7883

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

1 Aurora L Gonzalez Dr
Toledo, OH 43609-2783

Mailing address

313 Jefferson Ave
Toledo, OH 43604-1004
Phone (419) 720-7883

Other names 1

  • NHA Senior Care Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20171110001189 OH Part B Supplier - Clinic/Group Practice 5698686665 Receives reassigned benefits from 25 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Toledo, OH
O20240501001399 OH Part A Provider - Federally Qualified Health Center (FQHC) 5698686665 Practice locations: Toledo, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1427170679. Details of each certification follow.

Federally qualified health center certification: CCN D21036

Legal name
NEIGHBORHOOD HEALTH ASSOCIATION OF TOLEDO, INC
Doing business as
NHA SENIOR CARE CLINIC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 11, 2024
Last certification
Jul 11, 2024
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Oct 1, 1969 in OH
Enrollment address
1 Aurora L Gonzalez Dr
Toledo, OH 43609-2783

Other NPIs with the same Medicare PAC ID 10

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Neighborhood Health Association16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

Organizations that report the same tax identification number in the National Provider Directory.

View all 15

Locations

1014 Jefferson Ave
Toledo, OH 43604

1250 Western Ave
Toledo, OH 43609

2101 Jefferson Ave
Toledo, OH 43604
Phone (419) 241-1554

313 Jefferson Ave
Toledo, OH 43604
Phone (419) 214-1770

Ownership & related parties

All disclosed owners & managing parties 11

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Talmadge Thomas Individual Corporate DirectorPresident of Board Sep 27, 2019
Jodi Gross Individual Corporate DirectorBoard Member Apr 1, 2018
Jose Balderas Individual Corporate DirectorBoard Member Sep 27, 2019
Jerry Boose Individual Corporate DirectorBoard Member Jan 1, 2023
Shane Douglas Individual Corporate DirectorCoo Jan 3, 2023
W-2 Managing EmployeeCoo Jan 2, 2023
Ward Barnett Individual Corporate DirectorBoard Member Jan 1, 2023
Angela Jordan Individual Corporate DirectorSecretary of Board Sep 27, 2019
Michael Alexander Individual Corporate DirectorBoard Member May 1, 2014
Christopher Kiehl Individual Corporate DirectorBoard Member Sep 27, 2019
Jennifer Discher Individual Corporate DirectorVice President of Board Mar 1, 2011
Doni Miller Individual Corporate DirectorCeo Mar 1, 1993
W-2 Managing EmployeeCeo Mar 1, 1993

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Nexus Health CareToledo, OH, CCN 361105 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) May 1, 2016

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 21

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.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708473600000",
    "number": "1427170679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "313 JEFFERSON AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436041004",
            "telephone_number": "419-720-7883",
            "fax_number": "419-720-7896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 AURORA L GONZALEZ DR",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436092783",
            "telephone_number": "419-241-4230",
            "fax_number": "419-241-4231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEIGHBORHOOD HEALTH ASSOCIATION OF TOLEDO INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-06",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A",
        "authorized_official_last_name": "MILLER-CORBETT",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "419-720-7883"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NHA Senior Care Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.