Individual provider Active NPI

Carter John Newberry

  • Physician Assistant
  • Toledo, OH
National Provider Identifier
1891408688
Registry record updated Jan 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.008604RX Issued in OH
Practice address
3000 Arlington Ave # Ms 1027
Toledo, OH 43614-2595
Phone
(419) 530-5408
NPI assigned
Dec 27, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.008604RX OH Primary

Addresses

Primary practice location

3000 Arlington Ave # Ms 1027
Toledo, OH 43614-2595

Mailing address

4623 Lakeside Dr Unit 2201
Maumee, OH 43537-8573
Phone (815) 370-6415

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240329002698 OH Practitioner - Physician Assistant 7517305394 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Toledo College of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Promedica Central PhysiciansGroup PAC ID 2365348190, 785 clinicians

Practice addresses (Care Compare)

2109 Hughes Dr
Suite 450
Toledo, OH 43606-5102
Phone (419) 291-2003

2901 N Reynolds Rd
Toledo, OH 43606
Phone (419) 578-7700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Promedica Central Physicians Physician Assistant CurrentSince Mar 13, 2024 Accepting new patients
Promedica Central Physicians CurrentSince Mar 13, 2024 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

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

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

3000 Arlington Ave
#1027
Toledo, OH 43614
Phone (419) 383-5408

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

Interoperability endpoints

  • Direct secure messaging: cnewberry313749@direct.promedica.org

Organizations & group practices 3

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 5

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": "1672099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705881600000",
    "number": "1891408688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4623 LAKESIDE DR UNIT 2201",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435378573",
            "telephone_number": "815-370-6415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 ARLINGTON AVE # MS 1027",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436142595",
            "telephone_number": "419-530-5408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWBERRY",
        "first_name": "CARTER",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-12-27",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.008604RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.