Individual provider Active NPI

Chelsea Delynn Prince, PA-C

  • Medical Physician Assistant
  • Carrollton, OH
National Provider Identifier
1285930784
Registry record updated Jan 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
125 Canton Rd NW
Carrollton, OH 44615-1009
Phone
(330) 627-7641
NPI assigned
Jan 31, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

125 Canton Rd NW
Carrollton, OH 44615-1009

Mailing address

125 Canton Rd NW
Carrollton, OH 44615-1009
Phone (330) 627-7641

Other names 1

  • Chelsea Delynn Coconougher Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181220001240 OH Practitioner - Physician Assistant 9931444874 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cleveland Clinic Mercy HospitalGroup PAC ID 0547156796, 92 clinicians
Orthounited, Inc.Group PAC ID 9032197868, 89 clinicians

Practice addresses (Care Compare)

1330 Mercy Dr NW
Suite 200
Canton, OH 44708-2624
Phone (330) 489-1000

4760 Belpar St NW
Canton, OH 44718-3603
Phone (330) 492-9200

7442 Frank Ave NW
North Canton, OH 44720-7018
Phone (330) 305-0838

Hospital & facility affiliations

  • Mercy Medical Center Hospital, Canton, OH, CCN 360070
  • Aultman Hospital Hospital, Canton, OH, CCN 360084

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cleveland Clinic Mercy Hospital CurrentSince Nov 13, 2018 Accepting new patients
Orthounited, Inc. CurrentSince Jan 1, 2023 Accepting new patients

Locations

325 Springside Dr
Ste 101
Akron, OH 44333
Phone (330) 492-9200

2211 W State St
Alliance, OH 44601
Phone (330) 680-8735

4760 Belpar St NW
Canton, OH 44718
Phone (330) 244-1001

1330 Mercy Dr NW
Ste 200
Canton, OH 44708
Phone (330) 489-1000

125 Canton Rd NW
Carrollton, OH 44615
Phone (330) 627-7300

7442 Frank Ave NW
North Canton, OH 44720
Phone (330) 305-0838

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": "1296432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643328000000",
    "number": "1285930784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 CANTON RD NW",
            "city": "CARROLLTON",
            "state": "OH",
            "postal_code": "446151009",
            "telephone_number": "330-627-7641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 CANTON RD NW",
            "city": "CARROLLTON",
            "state": "OH",
            "postal_code": "446151009",
            "telephone_number": "330-627-7641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRINCE",
        "first_name": "CHELSEA",
        "middle_name": "DELYNN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-31",
        "last_updated": "2022-01-28",
        "certification_date": "2022-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHELSEA",
            "last_name": "COCONOUGHER",
            "middle_name": "DELYNN",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Carrollton, OH

Sources for this page

Verify at the official NPI Registry.