Individual provider Active NPI

Anthony F Ieraci

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Canfield, OH
National Provider Identifier
1467048470
Registry record updated Dec 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
License
5005902 Issued in OH
Practice address
3680 Starrs Centre Dr
Canfield, OH 44406-9514
Phone
(330) 967-4056
NPI assigned
Dec 14, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X 5005902 OH Primary

Addresses

Primary practice location

3680 Starrs Centre Dr
Canfield, OH 44406-9514

Mailing address

3680 Starrs Centre Dr
Canfield, OH 44406-9514

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5005902OHMDIntellectual and/or Developmental Disabilities Residential Treatment Facility

Practice roles

OrganizationSpecialtyStatusNew patients
Ieraci Homes LLC Residential Treatment Facility, Intellectual and/Or Developmental Disabilities Current Accepting new patients

Locations

3680 Starrs Centre Dr
Canfield, OH 44406
Phone (330) 402-0441

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1607904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607904000000",
    "number": "1467048470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3680 STARRS CENTRE DR",
            "city": "CANFIELD",
            "state": "OH",
            "postal_code": "444069514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3680 STARRS CENTRE DR",
            "city": "CANFIELD",
            "state": "OH",
            "postal_code": "444069514",
            "telephone_number": "330-967-4056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IERACI",
        "first_name": "ANTHONY",
        "middle_name": "F",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-12-14",
        "last_updated": "2020-12-14",
        "certification_date": "2020-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "OH",
            "license": "5005902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 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.