Individual provider Active NPI

Todd Forrest, DO

  • Family Medicine Physician
  • Maumee, OH
National Provider Identifier
1831187103
Registry record updated Jan 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
3845 Issued in OH
Practice address
119 Clinton St
Maumee, OH 43537-2811
Phone
(419) 893-8985
Fax
(419) 893-6766
NPI assigned
Oct 11, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2008

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 3845 OH Primary

Addresses

Primary practice location

119 Clinton St
Maumee, OH 43537-2811

Mailing address

119 Clinton St
Maumee, OH 43537-2811
Phone (419) 893-8985

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
I20060426000001 OH Practitioner - Family Practice 0244251684

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3845OHMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Todd Forrest DO LLC Family Medicine CurrentSince Mar 14, 2006 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

119 Clinton St
Maumee, OH 43537
Phone (419) 893-8867

118 E Indiana Ave
Maumee, OH 43537
Phone (419) 794-3026

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": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199404800000",
    "number": "1831187103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 CLINTON ST",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435372811",
            "telephone_number": "419-893-8985",
            "fax_number": "419-893-6766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 CLINTON ST",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435372811",
            "telephone_number": "419-893-8985",
            "fax_number": "419-893-6766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORREST",
        "first_name": "TODD",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-11",
        "last_updated": "2008-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "3845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maumee, OH

Sources for this page

Verify at the official NPI Registry.