NPIMap

Organization Active NPI

Carnation Clinic Inc

  • Multi-Specialty Clinic/Center
  • Alliance, OH
National Provider Identifier
1114092814
Registry record updated Jun 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
CARNATION CLINIC INC
Practice address
1401 S Arch Ave
Alliance, OH 44601-4202
Phone
(330) 821-0201
Fax
(330) 821-1924
NPI assigned
Nov 21, 2006
Last updated
Jun 9, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2010

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

Authorized official

Name
Mrs. Rasario Bautista
Title
Administrator MGR
Phone
(330) 821-0201

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

1401 S Arch Ave
Alliance, OH 44601-4202

Mailing address

1401 S Arch Ave
Alliance, OH 44601-4202
Phone (330) 821-0201

Other identifiers 3

IdentifierTypeStateIssuer
CK0913OtherOHRAILROAD MEDICARE
0103640MedicaidOH
127480600OtherOHFEDERAL EMPLOYEE BWC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276041600000",
    "number": "1114092814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 S ARCH AVE",
            "city": "ALLIANCE",
            "state": "OH",
            "postal_code": "446014202",
            "telephone_number": "330-821-0201",
            "fax_number": "330-821-1924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 S ARCH AVE",
            "city": "ALLIANCE",
            "state": "OH",
            "postal_code": "446014202",
            "telephone_number": "330-821-0201",
            "fax_number": "330-821-1924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARNATION CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2010-06-09",
        "status": "A",
        "authorized_official_last_name": "BAUTISTA",
        "authorized_official_first_name": "RASARIO",
        "authorized_official_title_or_position": "ADMINISTRATOR MGR",
        "authorized_official_telephone_number": "330-821-0201",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CK0913",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0103640",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL EMPLOYEE BWC",
            "identifier": "127480600",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alliance, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 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.