Organization Active NPI

House Call MD LLC

  • Family Medicine Physician
  • Youngstown, OH
National Provider Identifier
1356593065
Registry record updated Feb 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35.091967 Issued in OH
Legal business name
HOUSE CALL MD LLC
Practice address
150 Overhill Rd
Youngstown, OH 44512-1455
Phone
(330) 272-9840
Fax
(330) 423-0421
NPI assigned
Oct 14, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2011

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

Authorized official

Name
Dr. Ted W Faull, M.D.
Title
Sole Member
Phone
(330) 272-9840

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 35.091967 OH Primary

Addresses

Primary practice location

150 Overhill Rd
Youngstown, OH 44512-1455

Mailing address

PO Box 14397
Youngstown, OH 44514-7397
Phone (330) 758-2775

Other identifiers 2

IdentifierTypeStateIssuer
3007696MedicaidOH
35.091967OtherOHLICENSE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1223942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298332800000",
    "number": "1356593065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14397",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445147397",
            "telephone_number": "330-758-2775",
            "fax_number": "330-758-2787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 OVERHILL RD",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445121455",
            "telephone_number": "330-272-9840",
            "fax_number": "330-423-0421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOUSE CALL MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-14",
        "last_updated": "2011-02-22",
        "status": "A",
        "authorized_official_last_name": "FAULL",
        "authorized_official_first_name": "TED",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "330-272-9840",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35.091967",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3007696",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "35.091967",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 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.

Verify at the official NPI Registry.