Individual provider Active NPI

Kelly Marie Dorfmeister, FNP

  • Family Nurse Practitioner
  • Toledo, OH
National Provider Identifier
1679206163
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F07220050 Issued in OH
Practice address
1421 S Reynolds Rd
Toledo, OH 43615-7413
Phone
(419) 725-6290
NPI assigned
Jul 3, 2022
Last updated
Nov 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F07220050 OH Primary

Addresses

Primary practice location

1421 S Reynolds Rd
Toledo, OH 43615-7413

Mailing address

1421 S Reynolds Rd
Toledo, OH 43615-7413
Phone (419) 725-6290

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kdorfmeister217232@epicdirect.promedica.org

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221007001416 OH Practitioner - Nurse Practitioner 5597141929 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Toledo College of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Promedica Central PhysiciansGroup PAC ID 2365348190, 785 clinicians

Practice addresses (Care Compare)

3430 Secor Rd
Suite 425
Toledo, OH 43606-1547
Phone (567) 585-0225

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F07220050OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Promedica Central Physicians CurrentSince Feb 1, 2023 Accepting new patients
Promedica Central Physicians CurrentSince Feb 1, 2023 Accepting new patients

Locations

100 Madison Ave
Toledo, OH 43604
Phone (567) 585-1964

2109 Hughes Dr
Ste 450
Toledo, OH 43606
Phone (419) 251-3112

3430 Secor Rd
Ste 425
Toledo, OH 43606
Phone (567) 585-0225

Interoperability endpoints

  • Direct secure messaging: kdorfmeister217232@direct.promedica.org

Organizations & group practices 2

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1656806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1679206163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1421 S REYNOLDS RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436157413",
            "telephone_number": "419-725-6290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1421 S REYNOLDS RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436157413",
            "telephone_number": "419-725-6290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORFMEISTER",
        "first_name": "KELLY",
        "middle_name": "MARIE",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-03",
        "last_updated": "2023-11-03",
        "certification_date": "2022-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "F07220050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kdorfmeister217232@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.