Data Notice: All results sourced from the public CMS NPPES NPI Registry (45 CFR Part 162) — for healthcare administrative use only (credentialing, billing, insurance verification). Not for law enforcement or legal proceedings. Not affiliated with CMS, HHS, or the US Government. Verify critical details at npiregistry.cms.hhs.gov. No queries stored.
Export Provider Record NPI 1053455170
Promedica Central Physicians, Llc
Organization Subpart: NO
Active
NPI Number1053455170
NPI TypeNPI-2 Organization
SpecialtyPediatrics
Provider Details
NPI1053455170
NPI TypeNPI-2 Organization
StatusActive
Enumeration Date2007-02-20
Last Updated2022-07-21
Authorized OfficialKimberly Govan
Credentialing Specialist
Phone: 4198247221
Mailing Address1601 Brigham Dr, Suite 200
Perrysburg, OH 43551-7114
United States
Phone: (419) 872-7700 | Fax: (419) 874-0196
📍 View Map
Primary Practice Address1601 Brigham Dr, Suite 200
Perrysburg, OH 43551-7114
United States
Phone: (419) 872-7700 | Fax: (419) 874-0196
📍 View Map
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDOH0999273
Other (non-Medicare)OH5835390Aetna
Other (non-Medicare)OH=========-048Tricare
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
Yes208000000X – PediatricsOH
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About NPI 1053455170

Promedica Central Physicians, Llc is an organization registered in the CMS NPPES NPI Registry with NPI number 1053455170. The primary specialty listed is Pediatrics. The organization is located in Perrysburg, OH. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2007-02-20. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1053455170?

NPI 1053455170 belongs to Promedica Central Physicians, Llc, a Pediatrics in Perrysburg, OH. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.

Is NPI 1053455170 active?

The current status of NPI 1053455170 in the NPPES registry is Active. The record was last updated on 2022-07-21.

What specialty is NPI 1053455170?

NPI 1053455170 is classified under the taxonomy Pediatrics. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1053455170?

You can verify NPI 1053455170 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1053455170?

The primary practice address on file for NPI 1053455170 is 1601 Brigham Dr, Perrysburg, OH 43551-7114. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1053455170 issued?

NPI 1053455170 was first issued (enumerated) on 2007-02-20. The NPPES record was last updated on 2022-07-21.

Practice Location Map

Promedica Central Physicians, Llc is located at 1601 Brigham Dr, Perrysburg, OH. Use the map below to find directions or verify the practice location.

📍 1601 Brigham Dr, Perrysburg, OH 43551-7114  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Promedica Central Physicians, Llc. All records sourced from the CMS NPPES registry.

Data Verified from CMS NPPES Last synced: 2026-06-15 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162