Individual provider Active NPI

Matthew E. Edington, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Canton, OH
National Provider Identifier
1164919973
Registry record updated May 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
36.004025 Issued in OH
Practice address
4503 Fulton Dr NW
Canton, OH 44718-2331
Phone
(330) 956-4857
Fax
(330) 956-4912
NPI assigned
Apr 17, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Foot & Ankle Surgery Podiatrist 213ES0103X 36.004025 OH Primary

Addresses

Primary practice location

4503 Fulton Dr NW
Canton, OH 44718-2331

Mailing address

4503 Fulton Dr NW
Canton, OH 44718-2331
Phone (330) 956-4857

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210607002793 OH Practitioner - Podiatry 3173923521 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Stark County Foot & Ankle Clinic Foot & Ankle Surgery CurrentSince Jul 1, 2021 Accepting new patients
Stark County Foot & Ankle Clinic Foot & Ankle Surgery PastSince Jun 22, 2021 Accepting new patients

Locations

4503 Fulton Dr NW
Canton, OH 44718
Phone (330) 956-4857

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/18207/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1523923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622160000000",
    "number": "1164919973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4503 FULTON DR NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182331",
            "telephone_number": "330-956-4857",
            "fax_number": "330-956-4912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4503 FULTON DR NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182331",
            "telephone_number": "330-956-4857",
            "fax_number": "330-956-4912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDINGTON",
        "first_name": "MATTHEW",
        "middle_name": "E.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-17",
        "last_updated": "2021-05-28",
        "certification_date": "2021-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "OH",
            "license": "36.004025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.