Individual provider Active NPI

Martha E Harshbarger-Kelly, M.D.

  • Internal Medicine Physician
  • Ravenna, OH
National Provider Identifier
1396832333
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35-075827 Issued in OH
Practice address
3973 Loomis Pkwy
Suite D
Ravenna, OH 44266-1803
Phone
(330) 296-2819
Fax
(330) 296-9503
NPI assigned
Oct 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35-075827 OH Primary

Addresses

Primary practice location

3973 Loomis Pkwy
Suite D
Ravenna, OH 44266-1803

Mailing address

16100 Auburn Rd
Newbury, OH 44065-9104
Phone (440) 564-9408

Other identifiers 1

IdentifierTypeStateIssuer
2243763MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35-075827OHMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396832333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16100 AUBURN RD",
            "city": "NEWBURY",
            "state": "OH",
            "postal_code": "440659104",
            "telephone_number": "440-564-9408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3973 LOOMIS PKWY",
            "address_2": "SUITE D",
            "city": "RAVENNA",
            "state": "OH",
            "postal_code": "442661803",
            "telephone_number": "330-296-2819",
            "fax_number": "330-296-9503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARSHBARGER-KELLY",
        "first_name": "MARTHA",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35-075827",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2243763",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ravenna, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.