Individual provider Active NPI

Acqua Chatmon, APRN

  • Registered Nurse
  • Toledo, OH
National Provider Identifier
1720664055
Registry record updated Sep 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
365427 Issued in OH
Practice address
6147 Foxcroft Rd
Toledo, OH 43615-2601
Phone
(419) 699-6719
NPI assigned
Mar 18, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 365427 OH Primary

Addresses

Primary practice location

6147 Foxcroft Rd
Toledo, OH 43615-2601

Mailing address

4235 Secor Rd
Toledo, OH 43623-4231
Phone (866) 775-7217

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
I20220829001428 OH Practitioner - Nurse Practitioner 9931583762 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
365427OHMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Toledo Clinic Incorporated CurrentSince Aug 18, 2022 Accepting new patients
Toledo Clinic Incorporated CurrentSince Aug 18, 2022 Accepting new patients

Locations

4235 Secor Rd
Toledo, OH 43623
Phone (419) 214-4214

2142 N Cove Blvd
Toledo, OH 43606
Phone (419) 291-1111

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1616025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693526400000",
    "number": "1720664055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4235 SECOR RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234231",
            "telephone_number": "866-775-7217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6147 FOXCROFT RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436152601",
            "telephone_number": "419-699-6719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHATMON",
        "first_name": "ACQUA",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-18",
        "last_updated": "2023-09-01",
        "certification_date": "2023-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "365427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.