Olympic Urogynecology, LLC

Primary specialty

Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) PhysicianTaxonomy code 207VF0040X

License

35099119 Issued in OH

Legal business name

OLYMPIC UROGYNECOLOGY, LLC

Practice address

3009 Smith Rd Ste 400
Fairlawn, OH 44333-2670

Phone

(330) 953-3414

Fax

(877) 753-3179

NPI assigned

Mar 20, 2017

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Costas A Apostolis, MD

Title

Medical Director

Phone

(330) 953-3414

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ioannis Argyrios Apostolis, MD

  • General Practice Physician
  • Harmony, PA
  • NPI 1912206111
  NPD
• Shane Tyler Boyd, CRNP

  • Family Nurse Practitioner
  • Ellwood City, PA
  • NPI 1619619996
  NPD

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

{
    "created_epoch": "1489968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1043751357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3009 SMITH RD STE 400",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443332670",
            "telephone_number": "330-953-3414",
            "fax_number": "877-753-3179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3009 SMITH RD STE 400",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443332670",
            "telephone_number": "330-953-3414",
            "fax_number": "877-753-3179"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7641 Market St Ste 2",
            "address_purpose": "LOCATION",
            "city": "Youngstown",
            "state": "OH",
            "postal_code": "445125980",
            "country_code": "US",
            "telephone_number": "330-953-3414",
            "fax_number": "877-753-3179",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "OLYMPIC UROGYNECOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-20",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "APOSTOLIS",
        "authorized_official_first_name": "COSTAS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "330-953-3414",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207VF0040X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": "OH",
            "license": "35099119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0228002",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician in Fairlawn, OH
• Providers in Fairlawn, OH by specialty
• Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.