NPIMap

Organization Active NPI

Youngstown Ohio Hospital Company LLC

  • Internal Medicine Physician
  • Youngstown, OH
National Provider Identifier
1053620724
Registry record updated Oct 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
YOUNGSTOWN OHIO HOSPITAL COMPANY LLC
Practice address
500 Gypsy Lane
Youngstown, OH 44504-1315
Phone
(330) 884-4571
NPI assigned
Sep 29, 2010
Last updated
Oct 15, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2010

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

Authorized official

Name
Debbie Brewer
Title
Director
Phone
(877) 892-9813

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU
Internal Medicine Physician 207R00000X NU Primary
Pediatrics Physician 208000000X NU
Surgery Physician 208600000X NU

Addresses

Primary practice location

500 Gypsy Lane
Youngstown, OH 44504-1315

Mailing address

PO Box 1113
Youngstown, OH 44501-1113
Phone (330) 884-4571

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidOH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1285718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287100800000",
    "number": "1053620724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1113",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445011113",
            "telephone_number": "330-884-4571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 GYPSY LANE",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445041315",
            "telephone_number": "330-884-4571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUNGSTOWN OHIO HOSPITAL COMPANY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-29",
        "last_updated": "2010-10-15",
        "status": "A",
        "authorized_official_last_name": "BREWER",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "877-892-9813"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2010; 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.