Putnam County Primary Care LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PUTNAM COUNTY PRIMARY CARE LLC

Practice address

1740 N Perry St
Suite a
Ottawa, OH 45875-1173

Phone

(419) 523-0012

Fax

(419) 523-3416

NPI assigned

Sep 16, 2006

Last updated

Jul 1, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jeffrey S Eiden, MDNPI 1538118559

Title

Owner

Phone

(419) 523-0012

Specialties & licenses 2

Addresses

Other identifiers 3

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

CLIA laboratory certificates

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jeffrey S Eiden, MD

  • Family Medicine Physician
  • Ottawa, OH
  • NPI 1538118559
  NPD (past) Authorized official
• Leah Christine Eiden, MD

  • Family Medicine Physician
  • Bluffton, OH
  • NPI 1669421129
  NPD (past)
• Kristine Renee Kaufman, CNP

  • Family Nurse Practitioner
  • Ottawa, OH
  • NPI 1326098757
  NPD (past)

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214870400000",
    "number": "1588760383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 450718",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441450614",
            "telephone_number": "800-514-4390",
            "fax_number": "440-808-3675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 N PERRY ST",
            "address_2": "SUITE A",
            "city": "OTTAWA",
            "state": "OH",
            "postal_code": "458751173",
            "telephone_number": "419-523-0012",
            "fax_number": "419-523-3416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUTNAM COUNTY PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-16",
        "last_updated": "2008-07-01",
        "status": "A",
        "authorized_official_last_name": "EIDEN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "419-523-0012",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD CARE",
            "identifier": "DC4690",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2502401",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME",
            "identifier": "5597270001",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristin Phillips, PT, DPT
• Proactiv Physical Therapy
• Putnam County Board of Mental Retardation
• Putnam County Council on Aging, Inc.
• Putnam County Educational Service Center
• Putnam Heritage Assisted Living LLC
• Putnam Parkway Eyecare, LLC
• Augusta L Quinn, PCC
• Destiny Lee Ramos
• Kristin Rasberry

• Family Medicine Physician in Ottawa, OH
• Providers in Ottawa, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.