NPIMap

Organization Active NPI

Maumee Bay Family Practice, Inc.

  • Primary Care Clinic/Center
  • Oregon, OH
National Provider Identifier
1952403776
Registry record updated Apr 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
35078608R Issued in OH
Legal business name
MAUMEE BAY FAMILY PRACTICE, INC.
Practice address
4330 Navarre Ave
Suite 103
Oregon, OH 43616-3578
Phone
(419) 691-7820
Fax
(419) 691-7593
NPI assigned
Sep 2, 2006
Last updated
Apr 1, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2011

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

Authorized official

Name
Dr. Tara S Robinson, M.D.NPI 1689677890
Title
President Owner
Phone
(419) 691-7820

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 35078608R OH Primary

Addresses

Primary practice location

4330 Navarre Ave
Suite 103
Oregon, OH 43616-3578

Mailing address

4330 Navarre Ave
Suite 103
Oregon, OH 43616-3578
Phone (419) 691-7820

Other identifiers 2

IdentifierTypeStateIssuer
2343128MedicaidOH
724392MedicaidOH

National Provider Directory

National Provider Directory

Locations

4330 Navarre Ave
Ste 103
Oregon, OH 43616
Phone (419) 691-7820

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301616000000",
    "number": "1952403776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4330 NAVARRE AVE",
            "address_2": "SUITE 103",
            "city": "OREGON",
            "state": "OH",
            "postal_code": "436163578",
            "telephone_number": "419-691-7820",
            "fax_number": "419-691-7593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4330 NAVARRE AVE",
            "address_2": "SUITE 103",
            "city": "OREGON",
            "state": "OH",
            "postal_code": "436163578",
            "telephone_number": "419-691-7820",
            "fax_number": "419-691-7593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAUMEE BAY FAMILY PRACTICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-02",
        "last_updated": "2011-04-01",
        "status": "A",
        "authorized_official_last_name": "ROBINSON",
        "authorized_official_first_name": "TARA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "419-691-7820",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "OH",
            "license": "35078608R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2343128",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "724392",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oregon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 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.