Active NPI
Clinton Robert Merck
- Student in an Organized Health Care Education/Training Program
- Canton, OH
National Provider Identifier
1336443019
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- SV674174
- Practice address
- 4827 Cranberry Ave NW
Canton, OH 44709-1316 - Phone
- (330) 206-8217
- NPI assigned
- Jan 10, 2011
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | SV674174 | OH | Primary |
Addresses
Primary practice location
4827 Cranberry Ave NW
Canton, OH 44709-1316
Mailing address
4827 Cranberry Ave NW
Canton, OH 44709-1316
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SV674174 | OH | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1294617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1294617600000",
"number": "1336443019",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4827 CRANBERRY AVE NW",
"city": "CANTON",
"state": "OH",
"postal_code": "447091316"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4827 CRANBERRY AVE NW",
"city": "CANTON",
"state": "OH",
"postal_code": "447091316",
"telephone_number": "330-206-8217"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MERCK",
"first_name": "CLINTON",
"middle_name": "ROBERT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-01-10",
"last_updated": "2011-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "OH",
"license": "SV674174",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"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 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.