Active NPI
Mark C Speelman, MD
- Family Medicine Physician
- Medina, OH
National Provider Identifier
1437129582
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 35036382
- Practice address
- 970 E Washington St
Suite 4 B
Medina, OH 44256-3332 - Phone
- (330) 723-3256
- Fax
- (330) 722-6731
- NPI assigned
- Jan 23, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 35036382 | OH | Primary |
Addresses
Primary practice location
970 E Washington St
Suite 4 B
Medina, OH 44256-3332
Mailing address
970 E Washington St
Suite 4 B
Medina, OH 44256-3332
Phone (330) 723-3256
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0480840 | Medicaid | OH | |
| 720 | Other | OH | SUMMA |
| 000000129521 | Other | OH | ANTHEM |
| 791083847 | Other | OH | RAILROAD MEDICARE |
| 53453 | Other | OH | QUALCHOICE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 35036382 | OH | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1270425600000",
"number": "1437129582",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "970 E WASHINGTON ST",
"address_2": "SUITE 4 B",
"city": "MEDINA",
"state": "OH",
"postal_code": "442563332",
"telephone_number": "330-723-3256",
"fax_number": "330-722-6731"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "970 E WASHINGTON ST",
"address_2": "SUITE 4 B",
"city": "MEDINA",
"state": "OH",
"postal_code": "442563332",
"telephone_number": "330-723-3256",
"fax_number": "330-722-6731"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPEELMAN",
"first_name": "MARK",
"middle_name": "C",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-23",
"last_updated": "2010-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OH",
"license": "35036382",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0480840",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SUMMA",
"identifier": "720",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000129521",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "791083847",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "QUALCHOICE",
"identifier": "53453",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Medina, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.