Organization Active NPI

North Canton Family Physicians Inc

  • Internal Medicine Physician
  • North Canton, OH
National Provider Identifier
1235234196
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
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

Updated by the provider on Aug 22, 2020

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)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
0701888MedicaidOH

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D0343717North Canton Family Physicians133 Wilbur Dr NE, North Canton, OH 44720Certificate of waiverApr 30, 2028

National Provider Directory

National Provider Directory

NPI 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.

Verify at the official NPI Registry.