Individual provider Active NPI

Edward Thomas Schirack, DO

  • Gastroenterology Physician
  • Canton, OH
National Provider Identifier
1326064254
Registry record updated Jan 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
34003000 Issued in OH
Practice address
3722 Dressler Road NW
Canton, OH 44718
Phone
(330) 479-9000
Fax
(330) 477-5805
NPI assigned
Jul 14, 2006
Last updated
Jan 12, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 34003000 OH Primary

Addresses

Primary practice location

3722 Dressler Road NW
Canton, OH 44718

Mailing address

3722 Dressler Road NW
Canton, OH 44718
Phone (330) 479-9000

Other identifiers 1

IdentifierTypeStateIssuer
0543415MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address edwardschirack@uhps.allscirptsdirect.net

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
3000OHMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Gastroenterology Inc Gastroenterology CurrentSince Jul 1, 1986 Accepting new patients
CG Endoscopy Center LTD PastSince Jun 25, 2002 Accepting new patients
Uh Canton Endoscopy LLC PastSince Aug 31, 2018 Accepting new patients

Locations

3722 Dressler Rd NW
Canton, OH 44718
Phone (330) 479-4217

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610409600000",
    "number": "1326064254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3722 DRESSLER ROAD NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "44718",
            "telephone_number": "330-479-9000",
            "fax_number": "330-477-5805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3722 DRESSLER ROAD NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "44718",
            "telephone_number": "330-479-9000",
            "fax_number": "330-477-5805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHIRACK",
        "first_name": "EDWARD",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2021-01-12",
        "certification_date": "2021-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OH",
            "license": "34003000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0543415",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "edwardschirack@uhps.allscirptsdirect.net",
            "affiliation": "N",
            "address_1": "11100 Euclid Ave",
            "city": "Cleveland",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441061716",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2021; 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.