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PROMEDICA CENTRAL PHYSICIANS LLC NPI 1588091292


NPI Information

NPI: 1588091292
Provider Name: PROMEDICA CENTRAL PHYSICIANS LLC

Doing Business As: PROMEDICA AFTER HOURS

Classification: Nurse Practitioner - 363L00000X
Entity Type: Organization

CLIA Number: 36D2197473

Address:
1601 BRIGHAM DR
SUITE 150
PERRYSBURG, OH
ZIP 43551
Phone: (419) 291-0130
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PROMEDICA CENTRAL PHYSICIANS LLC is a nurse practitioner in Perrysburg, OH. The provider is (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. PROMEDICA CENTRAL PHYSICIANS LLC NPI is 1588091292. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Promedica After Hours.

The provider's business location address is:

1601 BRIGHAM DR
SUITE 150
PERRYSBURG, OH
ZIP 43551-114
Phone: (419) 291-0130
Fax: (419) 872-5396

The provider's authorized official is Kristin Knueven .
The authorized official title is Credentialing Coordinator and has the following contact phone number (419) 824-7469.

The CLIA number assigned to this NPI record is 36D2197473 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/27/2013 and was last updated on 9/27/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineOHIONo
2363LF0000XNurse PractitionerFamilyOHIONo
3363L00000XNurse PractitionerOHIOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10999273MEDICAIDOHIO
29302261MEDICARE PINOHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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