Active NPI
Pediatric Center of Canton, LLC
- Pediatrics Physician
- Canton, OH
National Provider Identifier
1194037150
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 34.008837
- Legal business name
- PEDIATRIC CENTER OF CANTON, LLC
- Practice address
- 4048 Dressler Rd NW Ste 203
Canton, OH 44718-2784 - Phone
- (330) 456-9939
- Fax
- (330) 456-3212
- NPI assigned
- Jul 7, 2010
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Julia Banta
- Title
- Om/Cma
- Phone
- (330) 456-9939
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 35.047428 | OH | |
| Pediatrics Physician | 208000000X | 34.008837 | OH | Primary |
Addresses
Primary practice location
4048 Dressler Rd NW Ste 203
Canton, OH 44718-2784
Mailing address
4048 Dressler Rd NW Ste 203
Canton, OH 44718-2784
Phone (330) 456-9939
Other practice location 1
1445 Harrison Ave. NW
Suite 300 & 306
Canton, OH 44708
Phone (330) 456-9939
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 36D1069123 | Pediatric Center of Canton LLC | Certificate of waiver | May 29, 2027 |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pediatrics Physician
- Canton, OH
- NPI 1588690549
-
- Pediatrics Physician
- Canton, OH
- NPI 1275748253
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1278460800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1753142400000",
"number": "1194037150",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4048 DRESSLER RD NW STE 203",
"city": "CANTON",
"state": "OH",
"postal_code": "447182784",
"telephone_number": "330-456-9939",
"fax_number": "330-456-3212"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4048 DRESSLER RD NW STE 203",
"city": "CANTON",
"state": "OH",
"postal_code": "447182784",
"telephone_number": "330-456-9939",
"fax_number": "330-456-3212"
}
],
"practiceLocations": [
{
"address_1": "1445 Harrison Ave. NW",
"address_2": "Suite 300 & 306",
"address_purpose": "LOCATION",
"city": "Canton",
"state": "OH",
"postal_code": "44708",
"country_code": "US",
"telephone_number": "330-456-9939",
"fax_number": "330-456-3212",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "PEDIATRIC CENTER OF CANTON, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2010-07-07",
"last_updated": "2025-07-22",
"certification_date": "2025-07-22",
"status": "A",
"authorized_official_last_name": "BANTA",
"authorized_official_first_name": "JULIA",
"authorized_official_title_or_position": "OM/CMA",
"authorized_official_telephone_number": "330-456-9939"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Pediatrics",
"state": "OH",
"license": "35.047428",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Pediatrics",
"state": "OH",
"license": "34.008837",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Canton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.