J. R. Coleman Community Renovation Corp.

Primary specialty

Home Modifications ContractorTaxonomy code 171WH0202X

Legal business name

J. R. COLEMAN COMMUNITY RENOVATION CORP.

Practice address

1731 Grace Ave NE
Canton, OH 44705-2261

Phone

(330) 455-3873

Fax

(330) 455-3934

NPI assigned

Aug 8, 2014

Last updated

Aug 8, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Tom Thompson

Title

Executive Director

Phone

(330) 455-3873

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1407456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407456000000",
    "number": "1114336625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1731 GRACE AVE NE",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447052261",
            "telephone_number": "330-455-3873",
            "fax_number": "330-455-3934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1731 GRACE AVE NE",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447052261",
            "telephone_number": "330-455-3873",
            "fax_number": "330-455-3934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J. R. COLEMAN COMMUNITY RENOVATION CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-08",
        "last_updated": "2014-08-08",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "TOM",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "330-455-3873",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "171WH0202X",
            "taxonomy_group": "",
            "desc": "Contractor, Home Modifications",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0809227",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vyshnavi Iswaravaka, MD
• Saketh Iswarawaka, MD
• Osamuedemen Iyoha, MD
• J & S Medical Specialities
• J Maxwell Services LLC
• J. R. Coleman Senior Outreach Services, Inc.
• Bernadette Jabour, DO
• Jack R. Baker, D.O., Inc.
• Anastasia H Jackson-Priester
• Amanda Jackson, QMHS 3YRS CMS

• Home Modifications Contractor in Canton, OH
• Providers in Canton, OH by specialty
• Home Modifications Contractor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 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.