NPIMap

Organization Active NPI

Neighborhood Health Association of Toledo, Inc.

Doing business as Nexus Health Care

  • Federally Qualified Health Center (FQHC)
  • Toledo, OH
National Provider Identifier
1861857732
Registry record updated Dec 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
NEIGHBORHOOD HEALTH ASSOCIATION OF TOLEDO, INC.
Doing business as
Nexus Health Care
Practice address
1415 Jefferson Ave
Toledo, OH 43604-5827
Phone
(419) 720-7883
Fax
(419) 720-7895
NPI assigned
Dec 21, 2015
Last updated
Dec 21, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2015

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

Authorized official

Name
Sandra D Miller-Corbett
Title
Ceo
Phone
(419) 720-7883

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

1415 Jefferson Ave
Toledo, OH 43604-5827

Mailing address

313 Jefferson Ave
Toledo, OH 43604-1004
Phone (419) 720-7883

Other names 1

  • Nexus Health Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20160512001035 OH Part A Provider - Federally Qualified Health Center (FQHC) 5698686665 Practice locations: Toledo, OH
O20171110001189 OH Part B Supplier - Clinic/Group Practice 5698686665 Receives reassigned benefits from 25 practitioners
1 other NPI on this enrollment
Practice locations: Toledo, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1861857732. Details of each certification follow.

Federally qualified health center certification: CCN 361105

Legal name
NEIGHBORHOOD HEALTH ASSOCIATION OF TOLEDO, INC
Doing business as
NEXUS HEALTH CARE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
May 16, 2016
Last certification
May 16, 2016
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Oct 1, 1969 in OH
Enrollment address
1415 Jefferson Ave
Toledo, OH 43604-5827

Other NPIs with the same Medicare PAC ID 10

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Neighborhood Health Association of Toledo Inc16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

Organizations that report the same tax identification number in the National Provider Directory.

View all 15

Ownership & related parties

All disclosed owners & managing parties 12

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Talmadge Thomas Individual Corporate DirectorBoard Member Sep 27, 2019
Jodi Gross Individual Corporate DirectorBoard Member Apr 1, 2018
Jose Balderas Individual Corporate DirectorBoard Member Sep 27, 2019
Jerry Boose Individual Corporate DirectorBoard Member Sep 27, 2019
Shane Douglas Individual Corporate OfficerCfo Jan 3, 2023
W-2 Managing EmployeeCfo Jan 3, 2023
Ward Barnett Individual Corporate DirectorBoard Member Sep 27, 2019
Angela Jordan Individual Corporate DirectorBoard Member Sep 27, 2019
Neighborhood Health Association of Toledo, Inc Organization, Toledo, OH Non-profit 5% Or Greater Direct Ownership Interest May 1, 2016 100%
Michael Alexander Individual Corporate DirectorBoard Member Jun 1, 2014
Christopher Kiehl Individual Corporate DirectorBoard Member Sep 27, 2019
Jennifer Discher Individual Corporate DirectorBoard Member Jan 7, 2010
Doni Miller Individual Corporate OfficerCeo Mar 1, 1993
W-2 Managing EmployeeCeo Mar 1, 1993

Owners & managing parties with NPI records 10

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 31

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 31

NPI Registry JSON

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

{
    "created_epoch": "1450656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450656000000",
    "number": "1861857732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "313 JEFFERSON AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436041004",
            "telephone_number": "419-720-7883",
            "fax_number": "419-720-7895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 JEFFERSON AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436045827",
            "telephone_number": "419-720-7883",
            "fax_number": "419-720-7895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEIGHBORHOOD HEALTH ASSOCIATION OF TOLEDO, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-21",
        "last_updated": "2015-12-21",
        "status": "A",
        "authorized_official_last_name": "MILLER-CORBETT",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "419-720-7883"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nexus Health Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.