Independence Health , Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

INDEPENDENCE HEALTH , INC.

Practice address

4235 Secor Rd
Toledo, OH 43623-4231

Phone

(419) 479-5832

NPI assigned

Apr 19, 2019

Organization subpart

No

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

Authorized official

Name

Mr. Michael E D'Eramo

Title

Chief Administrative Office

Phone

(419) 479-5832

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1555632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555632000000",
    "number": "1508429010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4235 SECOR RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234231",
            "telephone_number": "419-479-5832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4235 SECOR RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234231",
            "telephone_number": "419-479-5832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENCE HEALTH , INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-19",
        "last_updated": "2019-04-19",
        "status": "A",
        "authorized_official_last_name": "D'ERAMO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICE",
        "authorized_official_telephone_number": "419-479-5832",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2019; 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.