Addiction Outreach Clinic LTD

Primary specialty

Addiction Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084A0401X

Legal business name

ADDICTION OUTREACH CLINIC LTD

Practice address

819 McKay CT Ste 102
Boardman, OH 44512-5771

Phone

(330) 259-4849

Fax

(330) 629-2847

NPI assigned

Jan 24, 2012

Last updated

Nov 7, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Nicholas Anthony Atanasoff, D.O.NPI 1992762264

Title

Medical Director

Phone

(330) 259-4849

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nicholas A Atanasoff, D.O.

  • Psychiatry Physician
  • Boardman, OH
  • NPI 1992762264
  Medicare reassignment Care Compare group NPD Authorized official
• Amanda Adkins, APRN

  • Family Nurse Practitioner
  • Waverly, OH
  • NPI 1376432534
  Medicare reassignment Care Compare group NPD
• Denise Frindt, AGNP-C

  • Adult Health Nurse Practitioner
  • Chardon, OH
  • NPI 1689055634
  Medicare reassignment Care Compare group NPD
• Matthew Guy Gugliotti, M.D.

  • Family Medicine Physician
  • New Middletown, OH
  • NPI 1144456476
  Medicare reassignment Care Compare group NPD
• Danielle L Harris, CNS

  • Clinical Nurse Specialist
  • Brooklyn, OH
  • NPI 1992712327
  Medicare reassignment Care Compare group NPD
• Joseph Burton Masternick, D.O.

  • Family Medicine Physician
  • Boardman, OH
  • NPI 1669491569
  Medicare reassignment Care Compare group NPD
• Russell Allan Morrison III, D.O.

  • Family Medicine Physician
  • Youngstown, OH
  • NPI 1699773259
  Medicare reassignment Care Compare group NPD
• Matthew Thomas Rupert, LPCC-S, LICDC-CS

  • Counselor
  • Monroe, OH
  • NPI 1154667137
  Medicare reassignment Care Compare group NPD
• Susan R Sammons, APRN

  • Family Nurse Practitioner
  • Waverly, OH
  • NPI 1720522493
  Medicare reassignment Care Compare group NPD
• Douglas Kevin Stevens, CNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Canton, OH
  • NPI 1013474824
  Medicare reassignment Care Compare group NPD
• Donald Potter

  • Professional Counselor
  • Berea, OH
  • NPI 1396094181
  Medicare reassignment Care Compare group
• Sarah Deiger, LISW-S

  • Clinical Social Worker
  • Boardman, OH
  • NPI 1003260613
  Medicare reassignment NPD

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

{
    "created_epoch": "1327363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699315200000",
    "number": "1356612261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 BOARDMAN - CANFIELD ROAD",
            "address_2": "SUITE K-1",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "44512",
            "telephone_number": "330-259-4849",
            "fax_number": "330-629-2847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "819 MCKAY CT STE 102",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445125771",
            "telephone_number": "330-259-4849",
            "fax_number": "330-629-2847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADDICTION OUTREACH CLINIC LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-24",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A",
        "authorized_official_last_name": "ATANASOFF",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "330-259-4849",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Addiction Medicine (Psychiatry & Neurology) Physician in Boardman, OH
• Providers in Boardman, OH by specialty
• Addiction Medicine (Psychiatry & Neurology) Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2023; 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.

Verify at the official NPI Registry.