NPIMap

Organization Active NPI

Healthspan Integrated Care

  • Internal Medicine Physician
  • North Canton, OH
National Provider Identifier
1073941803
Registry record updated Oct 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
HEALTHSPAN INTEGRATED CARE
Practice address
4914 Portage St NW
North Canton, OH 44720-7249
Phone
(216) 265-8810
Fax
(216) 265-8890
NPI assigned
Oct 14, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2013

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

Authorized official

Name
Mr. David A Nowiski
Title
Cfo
Phone
(513) 639-3722

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X

Addresses

Primary practice location

4914 Portage St NW
North Canton, OH 44720-7249

Mailing address

615 Elsinore PL
Cincinnati, OH 45202-1459
Phone (513) 639-2722

National Provider Directory

National Provider Directory
Tax ID family
Healthspan Integrated Care23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

Organizations that report the same tax identification number in the National Provider Directory.

View all 22

Locations

4914 Portage St NW
North Canton, OH 44720
Phone (330) 493-2000

NPI Registry JSON

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

{
    "created_epoch": "1381708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381708800000",
    "number": "1073941803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 ELSINORE PL",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452021459",
            "telephone_number": "513-639-2722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4914 PORTAGE ST NW",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447207249",
            "telephone_number": "216-265-8810",
            "fax_number": "216-265-8890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHSPAN INTEGRATED CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-14",
        "last_updated": "2013-10-14",
        "status": "A",
        "authorized_official_last_name": "NOWISKI",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "513-639-3722",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2013; 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.