Active NPI
Alex Payne, D.O.
- Addiction Medicine (Internal Medicine) Physician
- Elyria, OH
National Provider Identifier
1164879094
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction Medicine (Internal Medicine) Physician
- License
- 34.014141
- Practice address
- 174 Midway Blvd
Elyria, OH 44035-2786 - Phone
- (440) 723-8997
- NPI assigned
- May 20, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Addiction Medicine (Internal Medicine) Physician | 207RA0401X | 34.014141 | OH | Primary |
| Internal Medicine Physician | 207R00000X | 34.014141 | OH |
Addresses
Primary practice location
174 Midway Blvd
Elyria, OH 44035-2786
Mailing address
174 Midway Blvd
Elyria, OH 44035-2786
Phone (440) 723-8997
Other practice location 1
87 Conservatory Dr
Barberton, OH 44203-4291
Phone (234) 334-0303
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34.014141 | OH | MD | Addiction Medicine (Internal Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pinnacle Treatment Centers Oh-VII, LLC | Current | Accepting new patients | |
| Pinnacle Treatment Centers Oh-III, LLC | Current | Accepting new patients |
Locations
87 Conservatory Dr
Barberton, OH 44203
Phone (234) 334-0303
174 Midway Blvd
Elyria, OH 44035
Phone (440) 324-5199
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Addiction (Substance Use Disorder) Counselor
- Austintown, OH
- NPI 1093257859
-
- Internal Medicine Physician
- Austintown, OH
- NPI 1629468061
-
- Methadone Clinic
- Barberton, OH
- NPI 1679064703
-
- Methadone Clinic
- Elyria, OH
- NPI 1295382646
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1463702400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1738627200000",
"number": "1164879094",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "174 MIDWAY BLVD",
"city": "ELYRIA",
"state": "OH",
"postal_code": "440352786",
"telephone_number": "440-723-8997"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "174 MIDWAY BLVD",
"city": "ELYRIA",
"state": "OH",
"postal_code": "440352786",
"telephone_number": "440-723-8997"
}
],
"practiceLocations": [
{
"address_1": "87 Conservatory Dr",
"address_purpose": "LOCATION",
"city": "Barberton",
"state": "OH",
"postal_code": "442034291",
"country_code": "US",
"telephone_number": "234-334-0303",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PAYNE",
"first_name": "ALEX",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-05-20",
"last_updated": "2025-02-04",
"certification_date": "2025-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RA0401X",
"taxonomy_group": "",
"desc": "Internal Medicine, Addiction Medicine",
"state": "OH",
"license": "34.014141",
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OH",
"license": "34.014141",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Elyria, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.