Active NPI
Eric Anthony Gietzen
- Health Service Psychologist
- Massillon, OH
National Provider Identifier
1225554348
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Service Psychologist
- Practice address
- 93 Rolling Park Dr N
Massillon, OH 44647-5196 - Phone
- (330) 617-7598
- NPI assigned
- Aug 21, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Service Psychologist | 103TH0100X | Primary |
Addresses
Primary practice location
93 Rolling Park Dr N
Massillon, OH 44647-5196
Mailing address
93 Rolling Park Drive North
Massillon, OH 44647
Phone (330) 617-7598
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 475186391 | Medicaid | OH |
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": "1503273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1225554348",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "93 ROLLING PARK DRIVE NORTH",
"city": "MASSILLON",
"state": "OH",
"postal_code": "44647",
"telephone_number": "330-617-7598"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "93 ROLLING PARK DR N",
"city": "MASSILLON",
"state": "OH",
"postal_code": "446475196",
"telephone_number": "330-617-7598"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIETZEN",
"first_name": "ERIC",
"middle_name": "ANTHONY",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-08-21",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TH0100X",
"taxonomy_group": "",
"desc": "Psychologist, Health Service",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "475186391",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Massillon, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.