Individual provider Active NPI

Louis Mario Laguardia, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Canton, OH
National Provider Identifier
1376374512
Registry record updated Aug 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN.CNP.0037088 Issued in OH
Practice address
4641 Fulton Dr NW
Canton, OH 44718-2384
Phone
(330) 433-6075
NPI assigned
Aug 9, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN.476678 OH
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN.CNP.0037088 OH Primary

Addresses

Primary practice location

4641 Fulton Dr NW
Canton, OH 44718-2384

Mailing address

4641 Fulton Dr NW
Canton, OH 44718-2384
Phone (330) 433-6075

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
I20241021004132 OH Practitioner - Nurse Practitioner 1850823451 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN.476678OHMDRegistered Nurse
APRN.CNP.0037088OHMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Child and Adolescent Behavioral Health CurrentSince Sep 3, 2024 Accepting new patients
Child and Adolescent Behavioral Health Past Accepting new patients

Locations

405 S Linden Ave
Alliance, OH 44601
Phone (330) 433-6075

4641 Fulton Dr NW
Canton, OH 44718
Phone (330) 433-6075

1801 Schneider St NE
Canton, OH 44721
Phone (330) 454-7917

919 2nd St NE
Canton, OH 44704
Phone (330) 454-7917

Organizations & group practices 2

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": "1723161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723161600000",
    "number": "1376374512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4641 FULTON DR NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182384",
            "telephone_number": "330-433-6075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4641 FULTON DR NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182384",
            "telephone_number": "330-433-6075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAGUARDIA",
        "first_name": "LOUIS",
        "middle_name": "MARIO",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-09",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.476678",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.0037088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.