Phenomenal Care Services LLC

Primary specialty

Private VehicleTaxonomy code 347C00000X

Legal business name

PHENOMENAL CARE SERVICES LLC

Doing business as

Phenomenal Care Services

Practice address

3040 Wicker St NE
Canton, OH 44721-2298

Phone

(234) 521-1318

NPI assigned

Jul 6, 2023

Last updated

Jul 6, 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

Mr. Darryl Wayne Peterson IINPI 1679117386

Title

Ceo

Phone

(234) 521-1318

Specialties & licenses 2

Addresses

Other names 1

• Phenomenal Care Services Doing business as

Practitioners 1

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.

• Darryl Wayne Peterson II

  • Mental Health Counselor
  • Canton, OH
  • NPI 1679117386
  NPD Authorized official

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

{
    "created_epoch": "1688601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688601600000",
    "number": "1376221713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44",
            "city": "MIDDLEBRANCH",
            "state": "OH",
            "postal_code": "446520044",
            "telephone_number": "234-521-1318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3040 WICKER ST NE",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447212298",
            "telephone_number": "234-521-1318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHENOMENAL CARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-06",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "DARRYL",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "234-521-1318",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "II"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Phenomenal Care Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Elizabeth Pfalzgraf
• Emily Pfefferl, LPC
• Taylor Pfister
• Richard Pham, M.D.
• June L. Phelps, PH.D.
• Harkiran Phgora, M.D.
• Philip H. Iffland, D.D.S., Inc.
• Beth Philley
• Alena M Phillips, MS, LPCC
• Austin Phillips, CRBA

• Private Vehicle in Canton, OH
• Providers in Canton, OH by specialty
• Private Vehicle in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2023; 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.