Reynolds Road Surgical Center LTD

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

0437AS Issued in OH

Legal business name

REYNOLDS ROAD SURGICAL CENTER LTD

Doing business as

Wildwood Surgical Center

Practice address

2865 N Reynolds Rd
Suite 190
Toledo, OH 43615-2068

Phone

(419) 578-7500

Fax

(419) 539-6320

NPI assigned

Apr 4, 2006

Organization subpart

No

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

Authorized official

Name

Kelly G Shirer, CASC

Title

Manager of Finance

Phone

(419) 578-7500

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Wildwood Surgical Center Doing business as

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Listed as

Reynolds Road Surgical Center LTDCCN 36C0001097

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• The Toledo Hospital

  • General Acute Care Hospital
  • Toledo, OH
  • NPI 1013918937

  Member Of

  NPD member

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Stephen Saddemi, M.D.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Toledo, OH
  • NPI 1588685473
  NPD

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

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398124800000",
    "number": "1447212535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2865 N REYNOLDS RD",
            "address_2": "SUITE 190",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436152068",
            "telephone_number": "419-578-7500",
            "fax_number": "419-539-6320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2865 N REYNOLDS RD",
            "address_2": "SUITE 190",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436152068",
            "telephone_number": "419-578-7500",
            "fax_number": "419-539-6320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REYNOLDS ROAD SURGICAL CENTER LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-04",
        "last_updated": "2014-04-22",
        "status": "A",
        "authorized_official_last_name": "SHIRER",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "MANAGER OF FINANCE",
        "authorized_official_telephone_number": "419-578-7500",
        "authorized_official_credential": "CASC"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "OH",
            "license": "0437AS",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARAMOUNT HEALTHCARE",
            "identifier": "03422",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000000156919",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2059669",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wildwood Surgical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Racquel Reyes
• Reynolds Behavioral Health LLC
• Reynolds Clinic LLC
• Reynolds Corners Dental
• Reynolds Road Fitness Center Inc.
• Lisa Reynolds Sautter, RN
• Benita L. Reynolds-Saaka
• Coretta Reynolds
• Dejah Reynolds
• Georgette Reynolds

• Ambulatory Surgical Clinic/Center in Toledo, OH
• Providers in Toledo, OH by specialty
• Ambulatory Surgical Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.