Promedica Cemtral Physicians, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PROMEDICA CEMTRAL PHYSICIANS, LLC

Doing business as

Family Practice of Toledo

Practice address

3740 W Sylvania Ave
Suite 100
Toledo, OH 43623-4461

Phone

(419) 473-6601

Fax

(419) 479-6966

NPI assigned

Feb 9, 2007

Last updated

Feb 18, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kimberly Govan

Title

Credentialing Supervisor

Phone

(419) 824-7221

Specialties & licenses 1

Addresses

Other names 1

• Family Practice of Toledo Doing business as

Locations

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203292800000",
    "number": "1689715989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3740 W SYLVANIA AVE",
            "address_2": "SUITE 100",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234461",
            "telephone_number": "419-473-6601",
            "fax_number": "419-479-6966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3740 W SYLVANIA AVE",
            "address_2": "SUITE 100",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234461",
            "telephone_number": "419-473-6601",
            "fax_number": "419-479-6966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROMEDICA CEMTRAL PHYSICIANS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-09",
        "last_updated": "2008-02-18",
        "status": "A",
        "authorized_official_last_name": "GOVAN",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "CREDENTIALING SUPERVISOR",
        "authorized_official_telephone_number": "419-824-7221"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Practice of Toledo",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Family Medicine Physician in Toledo, OH
• Providers in Toledo, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2008; 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.