Active NPI
North Canton Family Physicians Inc
- Internal Medicine Physician
- North Canton, OH
National Provider Identifier
1235234196
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- NORTH CANTON FAMILY PHYSICIANS INC
- Practice address
- 133 Wilbur Dr NE
North Canton, OH 44720 - Phone
- (330) 494-6012
- Fax
- (330) 494-0403
- NPI assigned
- Sep 14, 2006
- 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
- Marilyn Spragg Jenrette, MD
- Title
- President
- Phone
- (330) 494-6012
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | Primary |
Addresses
Primary practice location
133 Wilbur Dr NE
North Canton, OH 44720
Mailing address
PO Box 80690
Canton, OH 44708
Phone (330) 833-5530
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0701888 | Medicaid | OH |
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 |
|---|---|---|---|
| 36D0343717 | North Canton Family Physicians | Certificate of waiver | Apr 30, 2028 |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158192000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1235234196",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 80690",
"city": "CANTON",
"state": "OH",
"postal_code": "44708",
"telephone_number": "330-833-5530",
"fax_number": "330-833-6085"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "133 WILBUR DR NE",
"city": "NORTH CANTON",
"state": "OH",
"postal_code": "44720",
"telephone_number": "330-494-6012",
"fax_number": "330-494-0403"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NORTH CANTON FAMILY PHYSICIANS INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-14",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "JENRETTE",
"authorized_official_first_name": "MARILYN",
"authorized_official_middle_name": "SPRAGG",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "330-494-6012",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0701888",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in North Canton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.