Medcorp of Stark County, Inc.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

MEDCORP OF STARK COUNTY, INC.

Practice address

2500 Wales Ave NW
Massillon, OH 44646-2324

Phone

(330) 833-8996

Fax

(330) 833-6969

NPI assigned

Feb 9, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Deborah D Wilson

Title

Office Manager

Phone

(330) 833-8996

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248739200000",
    "number": "1013980044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 WALES AVE NW",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446462324",
            "telephone_number": "330-833-8996",
            "fax_number": "330-833-6969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 WALES AVE NW",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446462324",
            "telephone_number": "330-833-8996",
            "fax_number": "330-833-6969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDCORP OF STARK COUNTY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-09",
        "last_updated": "2009-07-28",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "330-833-8996",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0559908",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID NUMBER",
            "identifier": "9918911",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Meadow Wind Healthcare LLC
• Meals on Wheels of Stark & Wayne Counties
• Lateef Mealy
• Teela Mealy
• Telai Zekiah Mealy
• Medical Transport Systems Inc
• Lindsay E Meese, CDCA
• Samantha Meinhart
• Nathan Daniel Mellion, D.D.S., M.S.D.
• Theresa Mellion, DMD, MS

• Internal Medicine Physician in Massillon, OH
• Providers in Massillon, OH by specialty
• Internal Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2009; 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.