Individual provider Active NPI

Johnathon S. Ross, MD

  • Internal Medicine Physician
  • Toledo, OH
National Provider Identifier
1780678490
Registry record updated Oct 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35045022 Issued in OH
Practice address
2409 Cherry St
Suite 207
Toledo, OH 43608-2625
Phone
(419) 251-4696
Fax
(419) 251-3572
NPI assigned
Sep 8, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35045022 OH Primary

Addresses

Primary practice location

2409 Cherry St
Suite 207
Toledo, OH 43608-2625

Mailing address

2200 Jefferson Ave
4TH Floor
Toledo, OH 43624-1120
Phone (419) 251-2673

Other identifiers 1

IdentifierTypeStateIssuer
0428684MedicaidOH

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
I20051116000002 OH Practitioner - Family PracticePractitioner - Internal Medicine 8224057583 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35045022OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians-North LLC Internal Medicine CurrentSince Jul 1, 2009 Accepting new patients
Mercy Health Physicians - North, LLC CurrentSince Jul 1, 2009 Accepting new patients

Locations

2222 Cherry St
Ste 2300
Toledo, OH 43608
Phone (419) 251-8013

2409 Cherry St
Ste 207
Toledo, OH 43608
Phone (419) 251-4316

2213 Franklin Ave
Toledo, OH 43620
Phone (419) 251-2053

2200 Jefferson Ave
Fl 4
Toledo, OH 43604
Phone (419) 251-1400

2409 Cherry St
Ste 307
Toledo, OH 43608
Phone (419) 251-4696

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": "1126137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193270400000",
    "number": "1780678490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 JEFFERSON AVE",
            "address_2": "4TH FLOOR",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436241120",
            "telephone_number": "419-251-2673",
            "fax_number": "419-251-0916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2409 CHERRY ST",
            "address_2": "SUITE 207",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436082625",
            "telephone_number": "419-251-4696",
            "fax_number": "419-251-3572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "JOHNATHON",
        "middle_name": "S.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-08",
        "last_updated": "2007-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35045022",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0428684",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.