Julie Lynn Oberly, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

35076929O Issued in OH

Practice address

1401 South Main Street
Suite 101
North Canton, OH 44720

Phone

(330) 497-8636

Fax

(330) 497-8634

NPI assigned

Jul 17, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202256000000",
    "number": "1114944600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3111 LOTZ AVE SE",
            "city": "EAST CANTON",
            "state": "OH",
            "postal_code": "447309727",
            "telephone_number": "330-488-5404",
            "fax_number": "330-488-3047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 SOUTH MAIN STREET",
            "address_2": "SUITE 101",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "44720",
            "telephone_number": "330-497-8636",
            "fax_number": "330-497-8634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBERLY",
        "first_name": "JULIE",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2008-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35076929O",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2243594",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• 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 Feb 6, 2008; 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.