NPIMap

Organization Active NPI

Family Medicine Health & Wellness Center, Inc

  • Family Medicine Physician
  • Massillon, OH
National Provider Identifier
1265459259
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
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
Last updated
Aug 22, 2020By the provider in NPPES
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
Tracy Ann Kotnik, M.D.NPI 1619967957
Title
President
Phone
(330) 832-2280

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
2382372MedicaidOH

National Provider Directory

National Provider Directory

Locations

2859 Aaronwood Ave NE
Massillon, OH 44646
Phone (330) 832-2280

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

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": "",
            "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.

Verify at the official NPI Registry.