Stark County Internal Medicine Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

35076929-O Issued in OH

Legal business name

STARK COUNTY INTERNAL MEDICINE INC

Practice address

1401 S Main St
Suite 101
North Canton, OH 44720-4289

Phone

(330) 497-8636

Fax

(330) 497-8634

NPI assigned

Feb 6, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Julie Lynn Oberly, M.D.

Title

Owner

Phone

(330) 497-8636

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1202256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401840000000",
    "number": "1083892525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 S MAIN ST",
            "address_2": "SUITE 101",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447204289",
            "telephone_number": "330-497-8636",
            "fax_number": "330-497-8634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 S MAIN ST",
            "address_2": "SUITE 101",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447204289",
            "telephone_number": "330-497-8636",
            "fax_number": "330-497-8634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STARK COUNTY INTERNAL MEDICINE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-06",
        "last_updated": "2014-06-04",
        "status": "A",
        "authorized_official_last_name": "OBERLY",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "330-497-8636",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35076929-O",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2243594",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "SP00931",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christine Staley, COTA/L
• Heather J Stansberry, COTA/L
• Karen Starcher, COTA/L
• Lori Starcher
• Stark County Auditor
• Stark Pain Management
• Deborah Starr
• Start With Hope LLC
• Mary E Staus, MD
• Stacy Stearns

• Internal Medicine Physician in North Canton, OH
• Providers in North Canton, OH by specialty
• Internal Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2014; 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.