NPIMap

Organization Active NPI

Promedica Central Physician, LLC

Doing business as Sylvania Internal Medicine

  • Internal Medicine Physician
  • Toledo, OH
National Provider Identifier
1447394564
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
PROMEDICA CENTRAL PHYSICIAN, LLC
Doing business as
Sylvania Internal Medicine
Practice address
4129 N Holland Sylvania Rd
Toledo, OH 43623-4809
Phone
(419) 885-4231
Fax
(419) 885-5314
NPI assigned
Feb 20, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Kenya Dixon
Title
Credentialing Assistant
Phone
(419) 824-7288

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Primary

Addresses

Primary practice location

4129 N Holland Sylvania Rd
Toledo, OH 43623-4809

Mailing address

4129 N Holland Sylvania Rd
Toledo, OH 43623-4809
Phone (419) 885-4231

Other names 1

  • Sylvania Internal Medicine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Promedica Central Physician 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

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1447394564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4129 N HOLLAND SYLVANIA RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234809",
            "telephone_number": "419-885-4231",
            "fax_number": "419-885-5314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4129 N HOLLAND SYLVANIA RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234809",
            "telephone_number": "419-885-4231",
            "fax_number": "419-885-5314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROMEDICA CENTRAL PHYSICIAN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DIXON",
        "authorized_official_first_name": "KENYA",
        "authorized_official_title_or_position": "CREDENTIALING ASSISTANT",
        "authorized_official_telephone_number": "419-824-7288"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sylvania Internal Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.