NPIMap

Organization Active NPI

FSR of Parkman LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Warren, OH
National Provider Identifier
1487168084
Registry record updated Sep 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
FSR OF PARKMAN LLC
Practice address
4930 Enterprise Dr NW
Warren, OH 44481-8706
Phone
(330) 714-0938
NPI assigned
Nov 20, 2017
Last updated
Sep 3, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2025

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

Authorized official

Name
Elizabeth MerrittNPI 1780568949
Title
Compliance Director
Phone
(330) 369-8022

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

4930 Enterprise Dr NW
Warren, OH 44481-8706

Mailing address

4930 Enterprise Dr NW
Warren, OH 44481-8706
Phone (330) 369-8022

Other practice location 1

2507 Youngstown Rd SE Ste A
Warren, OH 44484-4402
Phone (330) 369-8022 ext. 136

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191001003039 OH Part B Supplier - Clinic/Group Practice 9830429000 Receives reassigned benefits from 11 practitioners
Practice locations: Warren, OH

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D2142754FSR of Parkman, LLC4930 Enterprise Drive, NW, Warren, OH 44481Certificate of waiverJan 17, 2028

National Provider Directory

National Provider Directory
Tax ID family
FSR of Parkman LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

4930 Enterprise Dr NW
Warren, OH 44481
Phone (330) 369-8022

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/parkmanrecovery/r4/

Practitioners & affiliated clinicians

Practitioners 131

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 131

NPI Registry JSON

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

{
    "created_epoch": "1511136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756857600000",
    "number": "1487168084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4930 ENTERPRISE DR NW",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444818706",
            "telephone_number": "330-369-8022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4930 ENTERPRISE DR NW",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444818706",
            "telephone_number": "330-714-0938"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2507 Youngstown Rd SE Ste A",
            "address_purpose": "LOCATION",
            "city": "Warren",
            "state": "OH",
            "postal_code": "444844402",
            "country_code": "US",
            "telephone_number": "330-369-8022 x136",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FSR OF PARKMAN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-20",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A",
        "authorized_official_last_name": "MERRITT",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "COMPLIANCE DIRECTOR",
        "authorized_official_telephone_number": "330-369-8022"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.