NPIMap

Individual provider Active NPI

Traci King, NP

  • Nurse Practitioner
  • Toledo, OH
National Provider Identifier
1881929636
Registry record updated Mar 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
COA.10902-NP Issued in OH
Practice address
2142 N Cove Blvd
Toledo, OH 43606-3895
Phone
(419) 291-3627
Fax
(419) 291-2142
NPI assigned
Oct 13, 2009
Last updated
Mar 2, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X COA.10902-NP OH Primary

Addresses

Primary practice location

2142 N Cove Blvd
Toledo, OH 43606-3895

Mailing address

2142 N Cove Blvd
Toledo, OH 43606-3895
Phone (419) 291-3627

Other names 1

  • Traci Gaynier Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, MI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20091111000402 OH Practitioner - Nurse Practitioner 5496893448 Reassigns benefits to 2 organizations
I20191203000142 MI Practitioner - Nurse Practitioner 5496893448 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Promedica Central PhysiciansGroup PAC ID 2365348190, 785 clinicians

Practice addresses (Care Compare)

5700 Monroe St
Sylvania, OH 43560-2767
Phone (567) 585-0005

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
COA.10902-NPOHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Promedica Central Physicians Nurse Practitioner CurrentSince Mar 1, 2024 Accepting new patients
The Toledo Hospital Current Accepting new patients
Promedica Central Physicians CurrentSince Mar 1, 2024 Accepting new patients
Observation Physicians of Northwest Ohio LLC CurrentSince Apr 1, 2021 Accepting new patients
The Toledo Hospital CurrentSince Aug 1, 2022 Accepting new patients
The Toledo Hospital CurrentSince Aug 1, 2022 Accepting new patients
Haematology-Oncology Associates of Ohio and Michigan PC Current Accepting new patients
Consultants in Laboratory Medicine of Greater Toledo Current Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

718 N Macomb St
Monroe, MI 48162
Phone (734) 212-3097

1075 Medical Center Pkwy
Maumee, OH 43537
Phone (567) 585-0800

5700 Monroe St
Sylvania, OH 43560
Phone (419) 473-6622

5700 Monroe St
Unit 206
Sylvania, OH 43560
Phone (419) 473-6601

2109 Hughes Dr
Ste 450
Toledo, OH 43606
Phone (419) 251-3112

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

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1255392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267488000000",
    "number": "1881929636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2142 N COVE BLVD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436063895",
            "telephone_number": "419-291-3627",
            "fax_number": "419-291-2142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2142 N COVE BLVD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436063895",
            "telephone_number": "419-291-3627",
            "fax_number": "419-291-2142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "TRACI",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-13",
        "last_updated": "2010-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "COA.10902-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACI",
            "last_name": "GAYNIER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.