Individual provider Active NPI

Lisa M Hughes, PA-C

  • Physician Assistant
  • Massillon, OH
National Provider Identifier
1417997313
Registry record updated Dec 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50000497 Issued in OH
Practice address
3300 Bailey St NW
Suite 104
Massillon, OH 44646-3613
Phone
(330) 837-3823
Fax
(330) 837-8313
NPI assigned
Jun 8, 2006
Last updated
Dec 12, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50000497 OH Primary

Addresses

Primary practice location

3300 Bailey St NW
Suite 104
Massillon, OH 44646-3613

Mailing address

3300 Bailey St NW
Suite 104
Massillon, OH 44646-3613
Phone (330) 837-3823

Other identifiers 1

IdentifierTypeStateIssuer
970022370OtherOHRAILROAD MEDICARE

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
50000497OHMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418342400000",
    "number": "1417997313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 BAILEY ST NW",
            "address_2": "SUITE 104",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446463613",
            "telephone_number": "330-837-3823",
            "fax_number": "330-837-8313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 BAILEY ST NW",
            "address_2": "SUITE 104",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446463613",
            "telephone_number": "330-837-3823",
            "fax_number": "330-837-8313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUGHES",
        "first_name": "LISA",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2014-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50000497",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "970022370",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Massillon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2014; 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.