Active NPI
Family Medicine Health & Wellness Center, Inc
- Family Medicine Physician
- Massillon, OH
National Provider Identifier
1265459259
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- FAMILY MEDICINE HEALTH & WELLNESS CENTER, INC
- Practice address
- 2859 Aaronwood Ave NE
Massillon, OH 44646-2371 - Phone
- (330) 832-2280
- Fax
- (330) 832-4732
- NPI assigned
- Jul 16, 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
- Tracy Ann Kotnik, M.D.
- Title
- President
- Phone
- (330) 832-2280
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
2859 Aaronwood Ave NE
Massillon, OH 44646-2371
Mailing address
2859 Aaronwood Ave NE
Massillon, OH 44646-2371
Phone (330) 832-2280
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2382372 | Medicaid | OH |
National Provider Directory
National Provider DirectoryLocations
2859 Aaronwood Ave NE
Massillon, OH 44646
Phone (330) 832-2280
Practitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Nurse Practitioner
- Canton, OH
- NPI 1073503322
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153008000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1265459259",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2859 AARONWOOD AVE NE",
"city": "MASSILLON",
"state": "OH",
"postal_code": "446462371",
"telephone_number": "330-832-2280",
"fax_number": "330-832-4732"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2859 AARONWOOD AVE NE",
"city": "MASSILLON",
"state": "OH",
"postal_code": "446462371",
"telephone_number": "330-832-2280",
"fax_number": "330-832-4732"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FAMILY MEDICINE HEALTH & WELLNESS CENTER, INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-16",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "KOTNIK",
"authorized_official_first_name": "TRACY",
"authorized_official_middle_name": "ANN",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "330-832-2280",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2382372",
"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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.