PROMEDICA ENT LLC (NPI# 1346529906) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346529906 |
| Entity Type | Organization |
| Organization Name | PROMEDICA ENT LLC |
| Other Organization Name | NORTHWEST OHIO ENT CONSULTANTS |
| Practice Address |
605 3rd Ave Bldg A Suite A Fremont OH 43420-3269 |
| Practice Telephone | 5672012260 |
| Practice Fax Number | 4198241772 |
| Mailing Telephone | 5672012260 |
| Mailing Fax Number | 4198241772 |
| Enumeration Date | 2011-08-12 |
| Last Update Date | 2011-08-12 |
| Authorized Official Name | AMY L BAHNSEN (CREDENTIALING SUPERVISOR) |
| Authorized Official Telephone | 4198247334 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Northwest Ohio ENT Consultants | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023313285 | Promedica Ent LLC | Otolaryngology | 506 Van Buren St, Fostoria, OH 44830-1533 | 2011-01-20 |
| 1568771087 | Promedica Ent LLC | Otolaryngology | 5855 Monroe St, Sylvania, OH 43560-2269 | 2010-10-01 |
| Street Address |
605 3RD AVE BLDG A SUITE A |
| City | FREMONT |
| State | OH |
| Zip Code | 43420-3269 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235127606 | James Mckinley Williams | Otolaryngology | 605 3rd Ave, Suite A, Fremont, OH 43420-3269 | 2005-10-11 |
| 1174087803 | Northwest Ohio Orthopedics and Sports Medicine, Inc | Durable Medical Equipment & Medical Supplies | 605 3rd Ave, Fremont, OH 43420-3269 | 2019-01-28 |
| 1306340617 | Jason William Lalone | Nurse Practitioner | 605 3rd Ave, Fremont, OH 43420 | 2018-03-21 |
| 1538546049 | Shelly Ann Lehmann | Nurse Practitioner | 605 3rd Ave, Fremont, OH 43420-3269 | 2015-05-05 |
| 1831401298 | Kelly Randall Md Inc | Specialist | 605 3rd Ave, Suite F, Fremont, OH 43420-3269 | 2010-07-13 |
| 1427231430 | Primary Care of Northwest Ohio, Inc | Family Medicine | 605 3rd Ave, Blg B Ste D, Fremont, OH 43420-3269 | 2007-12-12 |
| 1891731659 | John M Mauric | Family Medicine | 605 3rd Ave, Suite D, Fremont, OH 43420-3269 | 2006-06-21 |
| 1982679171 | Kelly Randall | Specialist | 605 3rd Ave, Suite F, Fremont, OH 43420-3269 | 2006-02-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225596570 | Trisha D Hamm | Nurse Practitioner | Walk In Urgent Care, 2180 Sean Dr., #6b, Fremont, OH 43420 | 2019-03-06 |
| 1558886051 | Kortney Blair Potridge | Homemaker | 1718 Buckland Avenue, Fremont, OH 43420 | 2017-08-07 |
| 1699134015 | Gentle Caring Dentistry of Fremont Ohio | Dentist | 2430 Enterprise St, Fremont, OH 43420 | 2016-02-12 |
| 1033574587 | Alyssa Dickman | Physical Therapy Assistant | 1310 Chestnut St, Fremont, OH 43420 | 2015-12-29 |
| 1437566734 | Michael Allen Koebel | Registered Nurse | 1728 Oak Harbor Rd, Fremont, OH 43420 | 2014-07-18 |
| 1598183774 | Harry D. Burger | Dentist | 567 Bartson Rd., Fremont, OH 43420 | 2014-04-03 |
| 1750706636 | Lori Fisher | Registered Nurse | 500 W. State St., Suite A, Fremont, OH 43420 | 2014-02-28 |
| 1699113001 | Cora Renea Minich | Massage Therapist | 510 Court Street, Fremont, OH 43420 | 2013-06-07 |
| 1477850071 | Parschauer Eye Center Inc | Eyewear Supplier (Equipment, not the service) | 126 S. Front St, Fremont, OH 43420 | 2011-02-16 |
| 1316260839 | Marla D Carlisle | Physician Assistant | 605 Third Avenue, Suite B, Fremont, OH 43420 | 2010-03-11 |
| Find all providers in zip 43420 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841428307 | Joshua Mark Matthews | Orthopaedic Surgery | 39180 Farwell Dr Ste 231, Fremont, CA 94538 | 2009-06-23 |
| 1225290752 | Andre Nicolas Gay | Orthopaedic Surgery | 39180 Farwell Dr Ste 110, Fremont, CA 94538-1015 | 2008-06-26 |
| 1356564991 | Heartland Orthopaedic and Sports Medicine Clinic LLC | Orthopaedic Surgery | 2740 N Clarkson Suite 100, Fremont, NE 68025-7716 | 2007-04-11 |
| 1497839708 | Max Moses | Orthopaedic Surgery | 2400 Country Dr, Suite 100, Fremont, CA 94536-5329 | 2006-10-24 |
| 1053323931 | Soheil Motamed | Orthopaedic Surgery | 39350 Civic Center Drive, Ste. 300, Fremont, CA 94538-2331 | 2006-08-12 |
| 1609888593 | Mission Peak Orthopaedic Medical Group, Inc | Orthopaedic Surgery | 39350 Civic Center Dr Ste 300, Fremont, CA 94538-2331 | 2006-08-12 |
| 1063446953 | Ricardo A. Molina | Orthopaedic Surgery | 39350 Civic Center Dr. Ste. 300, Fremont, CA 94538-2331 | 2006-07-10 |
| 1235193020 | Jan Eric Henstorf, M.d.apc | Orthopaedic Surgery | 38733 Stivers St, Fremont, CA 94536-5337 | 2006-04-17 |
| 1710962741 | Brett W Fischer | Orthopaedic Surgery | 3301 E Elkhorn Dr, Fremont, NE 68025-6239 | 2005-12-13 |
| 1700860236 | Christopher Langdon Ihle | Orthopaedic Surgery | 2740 N Clarkson Street, Fremont, NE 68025-7720 | 2005-11-29 |
| Find all providers in FREMONT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.