NPIMap

Organization Active NPI

Stark County Foot & Ankle Clinic

  • Foot & Ankle Surgery Podiatrist
  • Massillon, OH
National Provider Identifier
1023059102
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
OH36002987 Issued in OH
Legal business name
STARK COUNTY FOOT & ANKLE CLINIC
Practice address
323 Marion Ave NW
Suite 101
Massillon, OH 44646
Phone
(330) 837-7715
Fax
(330) 837-7645
NPI assigned
Jun 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Stacy Lynn Diehl
Title
Insurance Claims Processor
Phone
(330) 833-5692

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X OH36002987 OH Primary

Addresses

Primary practice location

323 Marion Ave NW
Suite 101
Massillon, OH 44646

Mailing address

323 Marion Ave NW
Suite 101
Massillon, OH 44646
Phone (330) 837-7715

Other identifiers 1

IdentifierTypeStateIssuer
2413650MedicaidOH

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/18207/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023059102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 MARION AVE NW",
            "address_2": "SUITE 101",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "44646",
            "telephone_number": "330-837-7715",
            "fax_number": "330-837-7645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 MARION AVE NW",
            "address_2": "SUITE 101",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "44646",
            "telephone_number": "330-837-7715",
            "fax_number": "330-837-7645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STARK COUNTY FOOT & ANKLE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DIEHL",
        "authorized_official_first_name": "STACY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "INSURANCE CLAIMS PROCESSOR",
        "authorized_official_telephone_number": "330-833-5692"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "OH",
            "license": "OH36002987",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2413650",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Massillon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.