NPIMap

Organization Active NPI

Wyandot Memorial Hospital

  • Emergency Medicine Physician
  • Upper Sandusky, OH
National Provider Identifier
1679758205
Registry record updated Dec 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
1296 Issued in OH
Legal business name
WYANDOT MEMORIAL HOSPITAL
Practice address
885 N Sandusky Ave
Upper Sandusky, OH 43351-1031
Phone
(419) 294-4991
Fax
(419) 294-2233
NPI assigned
Jan 2, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2009

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

Authorized official

Name
Joseph D'Ettorre
Title
Ceo
Phone
(419) 294-4991

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207P00000X 1296 OH Primary

Addresses

Primary practice location

885 N Sandusky Ave
Upper Sandusky, OH 43351-1031

Mailing address

885 N Sandusky Ave
Upper Sandusky, OH 43351-1031
Phone (419) 294-4991

Other identifiers 1

IdentifierTypeStateIssuer
9687512MedicaidOH

Other names 1

  • Wyandot Memorial Hospital Emergency Room Other name

National Provider Directory

National Provider Directory
Tax ID family
Wynadot Memorial Hospit10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1199232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260748800000",
    "number": "1679758205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "885 N SANDUSKY AVE",
            "city": "UPPER SANDUSKY",
            "state": "OH",
            "postal_code": "433511031",
            "telephone_number": "419-294-4991",
            "fax_number": "419-294-2233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "885 N SANDUSKY AVE",
            "city": "UPPER SANDUSKY",
            "state": "OH",
            "postal_code": "433511031",
            "telephone_number": "419-294-4991",
            "fax_number": "419-294-2233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYANDOT MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-02",
        "last_updated": "2009-12-14",
        "status": "A",
        "authorized_official_last_name": "D'ETTORRE",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "419-294-4991"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "1296",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9687512",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wyandot Memorial Hospital Emergency Room",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Upper Sandusky, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2009; 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.