Forum Health Services

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

Legal business name

FORUM HEALTH SERVICES

Doing business as

Elm Road Immediate Care

Practice address

2662 Elm Rd NE
Cortland, OH 44410-9393

Phone

(330) 841-3004

NPI assigned

Jun 10, 2006

Last updated

Aug 22, 2020By 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

Dr. Timothy J Niemi, M.D.

Title

Medical Director

Phone

(330) 841-3004

Specialties & licenses 1

Addresses

Other identifiers 6

Other names 1

• Elm Road Immediate Care Doing business as

Locations

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114968849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2662 ELM RD NE",
            "city": "CORTLAND",
            "state": "OH",
            "postal_code": "444109393",
            "telephone_number": "330-841-3004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2662 ELM RD NE",
            "city": "CORTLAND",
            "state": "OH",
            "postal_code": "444109393",
            "telephone_number": "330-841-3004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORUM HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NIEMI",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "330-841-3004",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2179913",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA GROUP NUMBER",
            "identifier": "7997187",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY GROUP NUMBER",
            "identifier": "1525808",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC PROV NUMBER",
            "identifier": "6600170",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM GROUP NUMBER",
            "identifier": "000000165909",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUALCHOICE NUMBER",
            "identifier": "94930",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elm Road Immediate Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ashley Feciuch
• Harvey Jay Feenstra, DC
• Abigail R Flask
• Joann Kathy Foley, QMHS
• Mary Ann Fontanarosa, M.D.
• Sandra Waddill Foster, PH.D.
• Rachel Ann Fox, PARA-PROFESSIONAL
• Sarah Foyle, DPM
• Fresenius Medical Care Youngstown, LLC (Renal Care Group Warren)
• De Anna Nichole Fuchilla

• Urgent Care Clinic/Center in Cortland, OH
• Providers in Cortland, OH by specialty
• Urgent Care Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.