Neurodevelopmental Center of Northwest Ohio

Primary specialty

SpecialistTaxonomy code 174400000X

License

35047115C Issued in OH

Legal business name

NEURODEVELOPMENTAL CENTER OF NORTHWEST OHIO

Practice address

28442 E River Rd
Suite 203
Perrysburg, OH 43551-2858

Phone

(419) 874-8447

Fax

(419) 874-8793

NPI assigned

Jan 30, 2006

Organization subpart

No

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

Authorized official

Name

Donald Ian Cameron, M.D.

Title

President Physician

Phone

(419) 874-8447

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318291200000",
    "number": "1932170834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28442 E RIVER RD",
            "address_2": "SUITE 203",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435512858",
            "telephone_number": "419-874-8447",
            "fax_number": "419-874-8793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28442 E RIVER RD",
            "address_2": "SUITE 203",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435512858",
            "telephone_number": "419-874-8447",
            "fax_number": "419-874-8793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEURODEVELOPMENTAL CENTER OF NORTHWEST OHIO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-30",
        "last_updated": "2011-10-11",
        "status": "A",
        "authorized_official_last_name": "CAMERON",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "IAN",
        "authorized_official_title_or_position": "PRESIDENT         PHYSICIAN",
        "authorized_official_telephone_number": "419-874-8447",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "OH",
            "license": "35047115C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000132630",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2868679",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL MUTUAL OF OHIO",
            "identifier": "293725208012",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Perrysburg, OH
• Providers in Perrysburg, OH by specialty
• Specialist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.