NPIMap

Organization Active NPI

Aultman Carrollton Immediate Care

  • Urgent Care Clinic/Center
  • Carrollton, OH
National Provider Identifier
1427149269
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
License
35074895 Issued in OH
Legal business name
AULTMAN CARROLLTON IMMEDIATE CARE
Practice address
1020 Trump Rd NW
Carrollton, OH 44615-8422
Phone
(330) 627-0091
NPI assigned
Sep 27, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Kayvaan Mir-Mohsen Mortazavi, MD
Title
MD
Phone
(330) 627-0091

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X 35074895 OH Primary

Addresses

Primary practice location

1020 Trump Rd NW
Carrollton, OH 44615-8422

Mailing address

1020 Trump Rd NW
Carrollton, OH 44615-8422
Phone (330) 627-0091

National Provider Directory

National Provider Directory
Tax ID family
Family Prac Ctr Canton14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

Locations

1020 Trump Rd NW
Carrollton, OH 44615
Phone (330) 627-0091

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1427149269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 TRUMP RD NW",
            "city": "CARROLLTON",
            "state": "OH",
            "postal_code": "446158422",
            "telephone_number": "330-627-0091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 TRUMP RD NW",
            "city": "CARROLLTON",
            "state": "OH",
            "postal_code": "446158422",
            "telephone_number": "330-627-0091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AULTMAN CARROLLTON IMMEDIATE CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MORTAZAVI",
        "authorized_official_first_name": "KAYVAAN",
        "authorized_official_middle_name": "MIR-MOHSEN",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "330-627-0091",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "OH",
            "license": "35074895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.