Individual provider Active NPI

Edward Glenn Myers, D.O.

  • Family Medicine Physician
  • Warren, OH
National Provider Identifier
1205806304
Registry record updated Jul 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4585 Issued in OH
Practice address
2581 North Rd NE
Warren, OH 44483-3052
Phone
(330) 372-5200
Fax
(330) 372-4437
NPI assigned
Jan 23, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4585 OH Primary

Addresses

Primary practice location

2581 North Rd NE
Warren, OH 44483-3052

Mailing address

6520 State Route 46
Cortland, OH 44410-9667
Phone (330) 637-4964

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100316000149 OH Practitioner - Family Practice 6507870649 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Triad Health Services LLCGroup PAC ID 9032367917, 252 clinicians

Practice addresses (Care Compare)

2581 N Rd NE
Warren, OH 44483-3052
Phone (330) 372-5200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.94 of 100Reported as group
Quality
71.12
Promoting interoperability
100
Improvement activities
40
Cost
75.36

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
4585OHMDCognitive & Behavioral Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Triad Health Services, LLC Family Medicine CurrentSince Dec 1, 2022 Accepting new patients
The Surgery Center at Southwoods, LLC Past Accepting new patients

Locations

2581 North Rd NE
Warren, OH 44483
Phone (330) 372-5200

7629 Market St
Ste 250
Youngstown, OH 44512
Phone (330) 729-9480

100 Debartolo Pl
Ste 200
Youngstown, OH 44512
Phone (330) 965-7828

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501113600000",
    "number": "1205806304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6520 STATE ROUTE 46",
            "city": "CORTLAND",
            "state": "OH",
            "postal_code": "444109667",
            "telephone_number": "330-637-4964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2581 NORTH RD NE",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444833052",
            "telephone_number": "330-372-5200",
            "fax_number": "330-372-4437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "EDWARD",
        "middle_name": "GLENN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-23",
        "last_updated": "2017-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "4585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, OH

Sources for this page

Verify at the official NPI Registry.