Individual provider Active NPI

Sally Ann Dingman, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Canton, OH
National Provider Identifier
1376301820
Registry record updated Mar 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0035976 Issued in OH
Practice address
4510 Dressler Rd NW
Canton, OH 44718-2546
Phone
(216) 450-1613
NPI assigned
Mar 11, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0035976 OH Primary

Addresses

Primary practice location

4510 Dressler Rd NW
Canton, OH 44718-2546

Mailing address

4510 Dressler Rd NW
Canton, OH 44718-2546
Phone (888) 494-1608

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240424000870 OH Practitioner - Nurse Practitioner 2668811654 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Recovery Concepts, LLCGroup PAC ID 5991005860, 37 clinicians

Practice addresses (Care Compare)

4510 Dressler Rd NW
Canton, OH 44718-2546
Phone (216) 450-1613

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0035976OHMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellness One Psychiatry PLLC Psychiatric/Mental Health Current Accepting new patients
Advanced Recovery Concepts LLC Psychiatric/Mental Health CurrentSince Jun 1, 2024 Accepting new patients
Axis Mental Health and Wellness Psychiatric/Mental Health PastSince Mar 17, 2024 Accepting new patients

Locations

25700 Science Park Dr
Ste 210
Beachwood, OH 44122
Phone (216) 452-1613

4510 Dressler Rd NW
Canton, OH 44718
Phone (330) 494-5155

1730 W 25th St
Cleveland, OH 44113
Phone (216) 696-4300

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1710115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1376301820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4510 DRESSLER RD NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182546",
            "telephone_number": "888-494-1608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4510 DRESSLER RD NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182546",
            "telephone_number": "216-450-1613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DINGMAN",
        "first_name": "SALLY",
        "middle_name": "ANN",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-11",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "0035976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.