Individual provider Active NPI

Ivor O'Connor Jr., MD

  • Internal Medicine Physician
  • Canton, OH
National Provider Identifier
1265939201
Registry record updated May 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35.141433 Issued in OH
Practice address
2600 Sixth St SW
Canton, OH 44710-1702
Phone
(330) 363-3870
Fax
(330) 363-3877
NPI assigned
Apr 6, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 24, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 35.141433 OH Primary

Addresses

Primary practice location

2600 Sixth St SW
Canton, OH 44710-1702

Mailing address

2600 Sixth St SW
Canton, OH 44710-1702
Phone (330) 363-3870

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210527003013 OH Practitioner - HospitalistPractitioner - Internal Medicine 1658770474 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohio Physician Professional CorporationGroup PAC ID 2668406059, 143 clinicians

Practice addresses (Care Compare)

2600 6TH SWST
Canton, OH 44710-1702
Phone (330) 363-2180

Hospital & facility affiliations

  • Aultman Hospital Hospital, Canton, OH, CCN 360084
  • Aultman Orrville Hospital Hospital, Orrville, OH, CCN 361323

Merit-based Incentive Payment System (MIPS)

Final score
89.96 of 100Reported as group
Quality
77.5
Promoting interoperability
99
Improvement activities
40
Cost
74.58

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35.141433OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ohio Physician Professional Corporation Internal Medicine CurrentSince Jun 30, 2021 Accepting new patients
Orrville Hospital Foundation Past Accepting new patients
Aultman Hospital Past Accepting new patients

Locations

2600 6th St SW
Canton, OH 44710
Phone (330) 363-2180

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1522972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621814400000",
    "number": "1265939201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 SIXTH ST SW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447101702",
            "telephone_number": "330-363-3870",
            "fax_number": "330-363-3877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 SIXTH ST SW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447101702",
            "telephone_number": "330-363-3870",
            "fax_number": "330-363-3877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNOR",
        "first_name": "IVOR",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-06",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.141433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.