Individual provider Active NPI

Vincent Carkido

  • Case Manager/Care Coordinator
  • Youngstown, OH
National Provider Identifier
1164091237
Registry record updated Jun 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
7690 South Ave
Youngstown, OH 44512-5723
Phone
(330) 758-0889
Fax
(330) 349-0178
NPI assigned
Jun 22, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

7690 South Ave
Youngstown, OH 44512-5723

Mailing address

7690 South Ave
Youngstown, OH 44512-5723
Phone (330) 758-0889

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1624320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624320000000",
    "number": "1164091237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7690 SOUTH AVE",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445125723",
            "telephone_number": "330-758-0889",
            "fax_number": "330-349-0178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7690 SOUTH AVE",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445125723",
            "telephone_number": "330-758-0889",
            "fax_number": "330-349-0178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARKIDO",
        "first_name": "VINCENT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-22",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2021; 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.