Individual provider Active NPI

Charles S Sheldon, D.O.

  • Internal Medicine Physician
  • Toledo, OH
National Provider Identifier
1568465425
Registry record updated Oct 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
34003664 Issued in OH
Practice address
2213 Cherry St Unit 2B
Toledo, OH 43608-2603
Phone
(419) 251-5155
Fax
(419) 251-5160
NPI assigned
May 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 34003664 OH Primary

Addresses

Primary practice location

2213 Cherry St Unit 2B
Toledo, OH 43608-2603

Mailing address

2200 Jefferson Ave FL 5
Toledo, OH 43604-7102

Other identifiers 1

IdentifierTypeStateIssuer
0565731MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051209000456 OH Practitioner - Internal Medicine 7911928650 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3664OHMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians-North LLC Internal Medicine CurrentSince Jan 1, 2014 Accepting new patients
Mercy Health Physicians - North, LLC CurrentSince Jan 1, 2014 Accepting new patients
Mercy Health System Northern PastSince Oct 19, 2020 Accepting new patients
Mercy Health - St Vincent Medical Center LLC Past Accepting new patients

Locations

1103 Village Square Dr
Ste 100
Perrysburg, OH 43551
Phone (419) 872-3213

1103 Village Square Dr
Perrysburg, OH 43551
Phone (419) 861-4022

2200 Jefferson Ave
Fl 5
Toledo, OH 43604
Phone (419) 251-9826

2213 Cherry St
Unit 2B
Toledo, OH 43608
Phone (419) 251-5155

2200 Jefferson Ave
Fl 4
Toledo, OH 43604
Phone (419) 251-1400

2213 Franklin Ave
Toledo, OH 43620
Phone (419) 251-2053

3900 Sunforest Ct
Ste 240
Toledo, OH 43623
Phone (419) 472-3126

2222 Cherry St
Ste 2300
Toledo, OH 43608
Phone (419) 251-8013

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602633600000",
    "number": "1568465425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 JEFFERSON AVE FL 5",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436047102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2213 CHERRY ST UNIT 2B",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436082603",
            "telephone_number": "419-251-5155",
            "fax_number": "419-251-5160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELDON",
        "first_name": "CHARLES",
        "middle_name": "S",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "34003664",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0565731",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.