NPIMap

Organization Active NPI

Lima Memorial Professional Corporation

Doing business as Lima Memorial Health System Northland Medical Center

  • Family Medicine Physician
  • Lima, OH
National Provider Identifier
1669758793
Registry record updated Apr 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LIMA MEMORIAL PROFESSIONAL CORPORATION
Doing business as
Lima Memorial Health System Northland Medical Center
Northland Family Practice
Practice address
240 W Northern Ave Ste 3
Lima, OH 45801-2839
Phone
(419) 998-8265
Fax
(419) 222-9057
NPI assigned
Nov 3, 2011
Last updated
Apr 9, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2022

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

Authorized official

Name
Jeffrey Utz
Title
Director of LMP
Phone
(419) 998-4668

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Nurse Practitioner 363L00000X
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

240 W Northern Ave Ste 3
Lima, OH 45801-2839

Mailing address

1001 Bellefontaine Ave
Lima, OH 45804-2800
Phone (419) 998-4575

Other identifiers 2

IdentifierTypeStateIssuer
1457474900OtherOHNPI
2223703MedicaidOH

Other names 2

  • Lima Memorial Health System Northland Medical Center Doing business as
  • Northland Family Practice Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040115000131 OH Part B Supplier - Clinic/Group Practice 1254232184 Receives reassigned benefits from 265 practitioners
19 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lima, OH; Novelty, OH; Ottawa, OH; Ottawa Hills, OH; Russells Point, OH; Sidney, OH; Solon, OH; Van Wert, OH…

Other NPIs on the same Medicare enrollment 11

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Lima Memorial Professional Corporation40 organizations share this tax ID, including this one

Other organizations with this tax ID 39

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

View all 39

Practitioners & affiliated clinicians

Practitioners 21

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.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1320278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649462400000",
    "number": "1669758793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 BELLEFONTAINE AVE",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458042800",
            "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": "240 W NORTHERN AVE STE 3",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458012839",
            "telephone_number": "419-998-8265",
            "fax_number": "419-222-9057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIMA MEMORIAL PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-03",
        "last_updated": "2022-04-09",
        "certification_date": "2022-04-09",
        "status": "A",
        "authorized_official_last_name": "UTZ",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "DIRECTOR OF LMP",
        "authorized_official_telephone_number": "419-998-4668"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1457474900",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2223703",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lima Memorial Health System Northland Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Northland Family Practice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Northland Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Apr 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.