Individual provider Active NPI

George W Vogelgesang, D.O.

  • Otolaryngology Physician
  • Massillon, OH
National Provider Identifier
1316924673
Registry record updated Jun 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
34-001983 Issued in OH
Practice address
3545 Lincoln Way E
Massillon, OH 44646-8624
Phone
(330) 837-3559
Fax
(330) 837-3052
NPI assigned
Dec 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 34-00-1983-V OH
Otolaryngology Physician 207Y00000X 34-001983 OH Primary

Addresses

Primary practice location

3545 Lincoln Way E
Massillon, OH 44646-8624

Mailing address

3545 Lincoln Way E
Massillon, OH 44646-8624
Phone (330) 837-3559

Other identifiers 1

IdentifierTypeStateIssuer
0201409MedicaidOH

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
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
34-001983OHMDOtolaryngology Physician

NPI Registry JSON

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

{
    "created_epoch": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275436800000",
    "number": "1316924673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3545 LINCOLN WAY E",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446468624",
            "telephone_number": "330-837-3559",
            "fax_number": "330-837-3052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3545 LINCOLN WAY E",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446468624",
            "telephone_number": "330-837-3559",
            "fax_number": "330-837-3052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VOGELGESANG",
        "first_name": "GEORGE",
        "middle_name": "W",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-28",
        "last_updated": "2010-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OH",
            "license": "34-00-1983-V",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "OH",
            "license": "34-001983",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0201409",
            "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 Jun 2, 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.

Verify at the official NPI Registry.