Active NPI
Timothy J Midura, PA C
- Medical Physician Assistant
- Barberton, OH
National Provider Identifier
1306954987
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 50000968
- Practice address
- 566 East Robinson Ave
Ste 400
Barberton, OH 44203 - Phone
- (330) 753-1015
- Fax
- (330) 753-3103
- NPI assigned
- Aug 25, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 50000968 | OH | Primary |
| Emergency Medicine Physician | 207P00000X | 50.000968 | OH |
Addresses
Primary practice location
566 East Robinson Ave
Ste 400
Barberton, OH 44203
Mailing address
10600Coal Bank Rd
Marshalville, OH 44645
Phone (330) 855-2065
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 50.000968 | OH | MD | Emergency Medicine Physician |
| 50000968 | OH | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1275350400000",
"number": "1306954987",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10600COAL BANK RD",
"city": "MARSHALVILLE",
"state": "OH",
"postal_code": "44645",
"telephone_number": "330-855-2065"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "566 EAST ROBINSON AVE",
"address_2": "STE 400",
"city": "BARBERTON",
"state": "OH",
"postal_code": "44203",
"telephone_number": "330-753-1015",
"fax_number": "330-753-3103"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIDURA",
"first_name": "TIMOTHY",
"middle_name": "J",
"name_prefix": "Mr.",
"credential": "PA C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-25",
"last_updated": "2010-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "OH",
"license": "50000968",
"primary": true
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "OH",
"license": "50.000968",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Barberton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.