Othello R Repuyan MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

OTHELLO R REPUYAN MD

Doing business as

Meridian Pediatrics of Canton LLC

Practice address

4188 Holiday St NW
Canton, OH 44718

Phone

(330) 492-4277

Fax

(330) 492-6973

NPI assigned

Sep 14, 2006

Organization subpart

No

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

Authorized official

Name

Othello R Repuyan, MD

Title

President

Phone

(330) 492-4277

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Meridian Pediatrics of Canton LLC Doing business as

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213660800000",
    "number": "1437254398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80690",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "44708",
            "telephone_number": "330-833-5530",
            "fax_number": "330-833-6085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4188 HOLIDAY ST NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "44718",
            "telephone_number": "330-492-4277",
            "fax_number": "330-492-6973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OTHELLO R REPUYAN MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2008-06-17",
        "status": "A",
        "authorized_official_last_name": "REPUYAN",
        "authorized_official_first_name": "OTHELLO",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "330-492-4277",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2651750",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Meridian Pediatrics of Canton LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Robert Ossler, CNP
• Zachary Kartanas Ostapowicz, DO
• Julie Oster, RN
• Anna Ostergren Furey
• Kelly Ostrout, M.ED, ED.S.
• Emmanuel Otomewo, M.D.
• Our Family Home Health Care, LLC
• Our Hearts Are Open Jones and Underwood
• Ouray Dental LLC
• Natasha M Overstreet

• Pediatrics Physician in Canton, OH
• Providers in Canton, OH by specialty
• Pediatrics Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2008; 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.