NPIMap

Individual provider Active NPI

Emmanuel Juane Tabora, M.D.

  • Family Medicine Physician
  • Lima, OH
National Provider Identifier
1538113253
Registry record updated Nov 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35.036923 Issued in OH
Practice address
525 N Eastown Rd
Suite a
Lima, OH 45807-2268
Phone
(419) 224-4646
Fax
(419) 224-2410
NPI assigned
May 19, 2006
Last updated
Nov 4, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35.036923 OH Primary

Addresses

Primary practice location

525 N Eastown Rd
Suite a
Lima, OH 45807-2268

Mailing address

951 Commerce Pkwy
Suite 101
Lima, OH 45804-4040
Phone (419) 998-4575

Other identifiers 3

IdentifierTypeStateIssuer
000000527468OtherOHANTHEM BCBS
0551924MedicaidOH
1538113253OtherOHANTHEM BCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35.036923OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Ohio Emergency Services, Inc. Past Accepting new patients
LMH Emergency Medicine Associates, LLC Past Accepting new patients
Epmg of Ohio Inc P a PastSince Aug 3, 2025 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415059200000",
    "number": "1538113253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "951 COMMERCE PKWY",
            "address_2": "SUITE 101",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458044040",
            "telephone_number": "419-998-4575",
            "fax_number": "419-998-4586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 N EASTOWN RD",
            "address_2": "SUITE A",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458072268",
            "telephone_number": "419-224-4646",
            "fax_number": "419-224-2410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABORA",
        "first_name": "EMMANUEL",
        "middle_name": "JUANE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2014-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35.036923",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000527468",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0551924",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "1538113253",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lima, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2014; 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.