Individual provider Active NPI

Roger Lee Wohlwend, D.O.

  • Family Medicine Physician
  • Toledo, OH
National Provider Identifier
1710982145
Registry record updated Jun 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34004668 Issued in OH
Practice address
4139 N Holland Sylvania Rd
Ste B
Toledo, OH 43623-2503
Phone
(419) 885-7212
Fax
(419) 885-7204
NPI assigned
Jun 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 34004668 OH Primary

Addresses

Primary practice location

4139 N Holland Sylvania Rd
Ste B
Toledo, OH 43623-2503

Mailing address

4139 N Holland Sylvania Rd
Ste B
Toledo, OH 43623-2503
Phone (419) 885-7212

Other identifiers 2

IdentifierTypeStateIssuer
P00234972OtherOHRAILROAD MEDICARE
0785637MedicaidOH

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040803001535 OH Practitioner - Family Practice 2062483050 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
34004668OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ohio Living Palliative Care Greater Toledo LLC Family Medicine CurrentSince Jun 19, 2018 Accepting new patients
Toledo Clinic Incorporated Past Accepting new patients
Mercy Health - St Vincent Medical Center LLC Past Accepting new patients
Wohlwend Family Medicine, Inc. Family Medicine Past Accepting new patients

Locations

904 Issac Sts
Oregon, OH 43616
Phone (419) 691-2483

9200 Worthington Rd
Ste 300
Westerville, OH 43082
Phone (614) 888-7800

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308614400000",
    "number": "1710982145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4139 N HOLLAND SYLVANIA RD",
            "address_2": "STE B",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436232503",
            "telephone_number": "419-885-7212",
            "fax_number": "419-885-7204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4139 N HOLLAND SYLVANIA RD",
            "address_2": "STE B",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436232503",
            "telephone_number": "419-885-7212",
            "fax_number": "419-885-7204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOHLWEND",
        "first_name": "ROGER",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2011-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34004668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00234972",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0785637",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.