Individual provider Active NPI

Darcy Jo Drevon, CNP

  • Family Nurse Practitioner
  • Massillon, OH
National Provider Identifier
1083003784
Registry record updated Nov 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
COA 16733-NP Issued in OH
Practice address
7452 Fulton Dr NW
Suite B
Massillon, OH 44646-9393
Phone
(330) 833-4596
Fax
(330) 833-1817
NPI assigned
Jan 19, 2015
Last updated
Nov 30, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X COA 16733-NP OH Primary

Addresses

Primary practice location

7452 Fulton Dr NW
Suite B
Massillon, OH 44646-9393

Mailing address

7452 Fulton Dr NW
Suite B
Massillon, OH 44646-9393
Phone (330) 833-4596

Other names 1

  • Darcy Jo Vrabel Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address darcy.drevon@chci.eclinicaldirectplus.com Community Health Care Inc.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150313000838 OH Practitioner - Nurse Practitioner 0840516696

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
COA 16733-NPOHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Radiology Associates of Canton, Inc. Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1421625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606694400000",
    "number": "1083003784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7452 FULTON DR NW",
            "address_2": "SUITE B",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446469393",
            "telephone_number": "330-833-4596",
            "fax_number": "330-833-1817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7452 FULTON DR NW",
            "address_2": "SUITE B",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446469393",
            "telephone_number": "330-833-4596",
            "fax_number": "330-833-1817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DREVON",
        "first_name": "DARCY",
        "middle_name": "JO",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-19",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA 16733-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "darcy.drevon@chci.eclinicaldirectplus.com",
            "affiliation": "Y",
            "affiliationName": "Community Health Care Inc.",
            "address_1": "7452 Fulton Dr NW",
            "address_2": "Suite B",
            "city": "Massillon",
            "state": "OH",
            "country_code": "US",
            "postal_code": "446469393",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "DARCY",
            "last_name": "VRABEL",
            "middle_name": "JO",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Massillon, OH

Sources for this page

Verify at the official NPI Registry.