NPIMap

Organization Active NPI

360Team Psychiatry LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Perrysburg, OH
National Provider Identifier
1780267146
Registry record updated May 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
360TEAM PSYCHIATRY LLC
Practice address
740 Commerce Dr Ste a
Perrysburg, OH 43551-5276
Phone
(502) 244-2420
Fax
(502) 996-8282
NPI assigned
May 4, 2021
Last updated
May 4, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2021

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

Authorized official

Name
Joe Vap
Title
General Manager
Phone
(502) 244-2420

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Psychiatric/Mental Health Nurse Practitioner 363LP0808X Primary

Addresses

Primary practice location

740 Commerce Dr Ste a
Perrysburg, OH 43551-5276

Mailing address

12910 Shelbyville Rd Ste 300
Louisville, KY 40243-2404
Phone (502) 244-2420

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210715002492 OH Part B Supplier - Clinic/Group Practice 4880096627 Receives reassigned benefits from 24 practitioners
Practice locations: Perrysburg, OH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1620086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620086400000",
    "number": "1780267146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12910 SHELBYVILLE RD STE 300",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402432404",
            "telephone_number": "502-244-2420",
            "fax_number": "502-996-8282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 COMMERCE DR STE A",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435515276",
            "telephone_number": "502-244-2420",
            "fax_number": "502-996-8282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "360TEAM PSYCHIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-04",
        "last_updated": "2021-05-04",
        "certification_date": "2021-05-04",
        "status": "A",
        "authorized_official_last_name": "VAP",
        "authorized_official_first_name": "JOE",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "502-244-2420"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Perrysburg, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.