NPIMap

Organization Active NPI

Promedica Northwest Ohio Cardiology Consultants, LLC

  • Cardiovascular Disease Physician
  • Port Clinton, OH
National Provider Identifier
1639458383
Registry record updated Aug 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
PROMEDICA NORTHWEST OHIO CARDIOLOGY CONSULTANTS, LLC
Practice address
615 Fulton St
Port Clinton, OH 43452-2001
Phone
(419) 734-3131
Fax
(419) 732-8217
NPI assigned
Aug 12, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2011

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

615 Fulton St
Port Clinton, OH 43452-2001

Mailing address

615 Fulton St
Port Clinton, OH 43452-2001
Phone (419) 734-3131

National Provider Directory

National Provider Directory
Tax ID family
Promedica Northwest Ohio Cardiology Consultants LLC11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

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": "1313107200000",
    "number": "1639458383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 FULTON ST",
            "city": "PORT CLINTON",
            "state": "OH",
            "postal_code": "434522001",
            "telephone_number": "419-734-3131",
            "fax_number": "419-732-8217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 FULTON ST",
            "city": "PORT CLINTON",
            "state": "OH",
            "postal_code": "434522001",
            "telephone_number": "419-734-3131",
            "fax_number": "419-732-8217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROMEDICA NORTHWEST OHIO CARDIOLOGY CONSULTANTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-12",
        "last_updated": "2011-08-12",
        "status": "A",
        "authorized_official_last_name": "BAHNSEN",
        "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": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Clinton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2011; 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.