NPIMap

Organization Active NPI

Promedica Central Physicians LLC

Doing business as Anita Antoniolli MD

  • Surgery Physician
  • Toledo, OH
National Provider Identifier
1629357371
Registry record updated Oct 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
PROMEDICA CENTRAL PHYSICIANS LLC
Doing business as
Anita Antoniolli MD
Practice address
2121 Hughes Dr
Suite 710
Toledo, OH 43606-3845
Phone
(419) 291-2610
Fax
(419) 480-6655
NPI assigned
Aug 12, 2011
Last updated
Oct 16, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2013

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

Authorized official

Name
Amy L Dwyer
Title
Credentialing Supervisor
Phone
(419) 824-7334

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X OH Primary

Addresses

Primary practice location

2121 Hughes Dr
Suite 710
Toledo, OH 43606-3845

Mailing address

2121 Hughes Dr
Suite 710
Toledo, OH 43606-3845
Phone (419) 291-2610

Other names 1

  • Anita Antoniolli MD 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": "1313107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381881600000",
    "number": "1629357371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 HUGHES DR",
            "address_2": "SUITE 710",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436063845",
            "telephone_number": "419-291-2610",
            "fax_number": "419-480-6655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 HUGHES DR",
            "address_2": "SUITE 710",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436063845",
            "telephone_number": "419-291-2610",
            "fax_number": "419-480-6655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROMEDICA CENTRAL PHYSICIANS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-12",
        "last_updated": "2013-10-16",
        "status": "A",
        "authorized_official_last_name": "DWYER",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CREDENTIALING SUPERVISOR",
        "authorized_official_telephone_number": "419-824-7334"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Anita Antoniolli MD",
            "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 Oct 16, 2013; 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.