Innovative Wound Care Associates Inc

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

2227258 Issued in OH

Legal business name

INNOVATIVE WOUND CARE ASSOCIATES INC

Practice address

790 Boardman Canfield Rd Ste 3
Boardman, OH 44512-4344

Phone

(330) 758-4862

Fax

(330) 758-4886

NPI assigned

Jul 12, 2013

Organization subpart

No

Name

John P BalkoNPI 1932104742

Title

President

Phone

(724) 347-0591

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

• John Balko, MD

  • Audiologist
  • Hermitage, PA
  • NPI 1932104742
  NPD (past) Authorized official

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 25, 2013.

{
    "created_epoch": "1373587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380067200000",
    "number": "1356782809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N KEEL RIDGE RD",
            "city": "HERMITAGE",
            "state": "PA",
            "postal_code": "161483440",
            "telephone_number": "724-347-0591",
            "fax_number": "724-347-4901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 BOARDMAN CANFIELD RD STE 3",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445124344",
            "telephone_number": "330-758-4862",
            "fax_number": "330-758-4886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE WOUND CARE ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-12",
        "last_updated": "2013-09-25",
        "status": "A",
        "authorized_official_last_name": "BALKO",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "724-347-0591"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "OH",
            "license": "2227258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cindy Huston, QMHS
• Jennifer Huston
• Kimberly L Hutchings, MSW, LISW-S
• Innovation Counseling and Wellness
• Innovative Family Wellness LLC
• Innovative Wound Care Associates, Inc
• International Pain and Rehabilitation Center, LLC
• Stevie Marie Iorio, DC
• Laura J.P. Isaacs, AUD, CCC-A, FAA
• Island Medical Vibra LLC

• All providers in Boardman, OH
• Vascular Surgery Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2013; 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.