Neighborhood Health Association of Toledo Inc.
Organization Active NPI Federally Qualified Health Center (FQHC) · Toledo, OH
NPI 1427170679 · NPPES record last updated Feb 21, 2024
Key facts
- NPI
- 1427170679
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- NEIGHBORHOOD HEALTH ASSOCIATION OF TOLEDO INC.
- Practice address
- 1 Aurora L Gonzalez Dr
Toledo, OH 43609-2783 - Phone
- (419) 241-4230
- Fax
- (419) 241-4231
- NPI assigned
- Apr 6, 2007
- Organization subpart
- No
Authorized official
- Name
- Sandra D Miller-Corbett
- Title
- Ceo
- Phone
- (419) 720-7883
Owned or controlled facilities with NPI records 1
Other NPIs on the same Medicare enrollment 1
Other NPIs with the same Medicare PAC ID 10
Corporate family (same tax ID) 15
Practitioners 23
-
Karen A. Tormoehlen, CNP
-
Tamara Bumpus, NP-C
-
Ryan Oertell Lakin, M.D.
-
Lauri Renee Oakes, APRN
-
Melanie C. Schell, FNP-BC
-
Katelyn C. Smith, LPC
-
Barbara Joan Francis, CNM
-
Danielle Lee Goodell, CNP
-
Wendy D. Goodrich, FNP-C
-
Gregory Kuehnl Kramp, PHARMD
-
Megan Lutz, MD
-
Maddison Metcalf, PA-C
-
Darla Mitchell, CNM
-
John Obinna Uche, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in OH
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
- Corporation · Non-profit
- Incorporated
- Oct 1, 1969 in OH
- Enrollment address
- 1 Aurora L Gonzalez Dr
Toledo, OH 43609-2783
All disclosed owners & managing parties 11
| Name | Role | Since | Share |
|---|---|---|---|
| Talmadge Thomas |
Corporate Director |
Sep 27, 2019 | |
| Jodi Gross |
Corporate Director |
Apr 1, 2018 | |
| Jose Balderas |
Corporate Director |
Sep 27, 2019 | |
| Jerry Boose |
Corporate Director |
Jan 1, 2023 | |
| Shane Douglas |
Corporate Director |
Jan 3, 2023 | |
| W-2 Managing Employee |
Jan 2, 2023 | ||
| Ward Barnett |
Corporate Director |
Jan 1, 2023 | |
| Angela Jordan |
Corporate Director |
Sep 27, 2019 | |
| Michael Alexander |
Corporate Director |
May 1, 2014 | |
| Christopher Kiehl |
Corporate Director |
Sep 27, 2019 | |
| Jennifer Discher |
Corporate Director |
Mar 1, 2011 | |
| Doni Miller |
Corporate Director |
Mar 1, 1993 | |
| W-2 Managing Employee |
Mar 1, 1993 |
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| Nexus Health Care |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | May 1, 2016 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
- Tax ID family
- Neighborhood Health Association of Toledo Inc
Locations
1014 Jefferson Ave
Toledo, OH 43604
923 N Huron St
Toledo, OH 43604
Phone (419) 242-6028
1250 Western Ave
Toledo, OH 43609
1425 Starr Ave
Toledo, OH 43605
Phone (419) 259-4506
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
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 identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2516209 | Medicaid | OH | |
| 01403 | Other | OH | PARAMOUNT |
Other names
- NHA Senior Care Clinic
Other providers in Toledo, OH
- Mary Ann Nehls
- Dana Michelle Neiding
- Neighborhood Health Association
- Neighborhood Health Association of Toledo Inc.
- Neighborhood Health Association of Toledo Inc.
- Neighborhood Health Association of Toledo Inc.
- Neighborhood Health Association of Toledo, Inc
- Neighborhood Health Association of Toledo, Inc
- Neighborhood Health Association of Toledo, Inc
- Neighborhood Health Association of Toledo, Inc.
All providers in Toledo, OH · Federally Qualified Health Center (FQHC) in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 21, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.