WILDWOOD FAMILY PRACTICE
NPI 1548304074
Family Medicine - Sports Medicine in Toledo, OH
NPI Status: Active since February 17, 2007
Contact Information
2865 N REYNOLDS RD
SUITE 130
TOLEDO, OH
ZIP 43615
Phone: (419) 578-7036
Fax: (419) 537-5597
- Organization
- Family Medicine
- Sports Medicine
- CLIA Number: 36D2030792
- CLIA Cert. Type: Hospital
- CLIA Exp. Date: 10-04-2027
About WILDWOOD FAMILY PRACTICE
This page provides the complete NPI Profile along with additional information for Wildwood Family Practice, a primary care provider established in Toledo, Ohio operating as a Family Medicine, focusing in sports medicine . The healthcare provider is registered in the NPI registry with number 1548304074 assigned on February 2007. The practitioner's primary taxonomy code is 207QS0010X. The provider is registered as an organization and their NPI record was last updated 18 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The provider's is doing business as Wildwood Family Practice. The authorized official of this NPI record is Kenya Dixon (Credentialing Assistant)
- NPI
- 1548304074
- Provider Legal Name
- PROMEDICA CENTRAL PHYSICIANS, LLC
- Other Organization Name
- WILDWOOD FAMILY PRACTICE
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 2865 N REYNOLDS RD SUITE 130 TOLEDO, OH 43615
- Location Phone
- (419) 578-7036
- Location Fax
- (419) 537-5597
- Mailing Address
- 2865 N REYNOLDS RD SUITE 130 TOLEDO, OH 43615
- Mailing Phone
- (419) 578-7036
- Mailing Fax
- (419) 537-5597
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 02-17-2007
- Last Update Date
- 02-18-2008
- Code Navigator
A primary care provider (PCP) like Wildwood Family Practice sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Family Medicine Sports Medicine
- Taxonomy Code
- 207QS0010X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207RS0010X | Allopathic & Osteopathic Physicians | Internal Medicine | |
| 2 | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics |
Group Taxonomy 193400000X MULTIPLE SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| PR9305778 | MEDICARE ID-TYPE UNSPECIFIED (04) | OH | |
| 4036950013 | MEDICARE NSC (07) | OH |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 36D2030792
- Facility Type
- Hospital
- Certificate Effective Date
- October 05, 2025
- Certificate Expiration Date
- October 04, 2027
- Laboratory Director
- NICOLE HUBBARD
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Wildwood Family Practice to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1548304074, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 66. The final step is to find the difference between that total and the next multiple of ten (70 - 66 = 4).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 66 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
TOLEDO, OH 43615
TOLEDO, OH 43615
TOLEDO, OH 43615
TOLEDO, OH 43615
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1548304074, enumerated as an "organization" on February 17, 2007.
The provider is located at 2865 N REYNOLDS RD SUITE 130 TOLEDO, OH 43615 and the phone number is (419) 578-7036.
Family Medicine with taxonomy code 207QS0010X and a focus in Sports Medicine.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
