Active NPI
Marissa Cancilla, PT
- Physical Therapist
- North Canton, OH
National Provider Identifier
1346533916
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT. 09464
- Practice address
- 339 E Maple St
North Canton, OH 44720-2593 - Phone
- (330) 498-8239
- NPI assigned
- May 16, 2011
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT. 09464 | OH | Primary |
Addresses
Primary practice location
339 E Maple St
North Canton, OH 44720-2593
Mailing address
339 E Maple St
North Canton, OH 44720-2593
Phone (330) 498-8239
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4 Berea CMNS
Berea, OH 44017-2524
Phone (440) 399-6302
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT. 09464 | OH | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Healthpro Heritage Rehab & Fitness, LLC | Physical Therapist | Current | Accepting new patients |
| Healthpro Heritage Rehab & Fitness, LLC | Physical Therapist | Current | Accepting new patients |
Locations
4 Berea Cmns
Berea, OH 44017
Phone (440) 243-9050
Organizations & group practices 2
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.
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- NPI 1871072462
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1305504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1305504000000",
"number": "1346533916",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "339 E MAPLE ST",
"city": "NORTH CANTON",
"state": "OH",
"postal_code": "447202593",
"telephone_number": "330-498-8239"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "339 E MAPLE ST",
"city": "NORTH CANTON",
"state": "OH",
"postal_code": "447202593",
"telephone_number": "330-498-8239"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANCILLA",
"first_name": "MARISSA",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-05-16",
"last_updated": "2011-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OH",
"license": "PT. 09464",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in North Canton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.