Individual provider Active NPI

Marcia Lynn Kiesling, CNP

  • Family Nurse Practitioner
  • Canton, OH
National Provider Identifier
1497005334
Registry record updated Aug 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
13853-NP Issued in OH
Practice address
2600 Sixth St SW
Canton, OH 44710-1702
Phone
(330) 363-6211
Fax
(330) 580-5513
NPI assigned
Sep 19, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 13853 OH
Family Nurse Practitioner 363LF0000X 13853-NP OH Primary

Addresses

Primary practice location

2600 Sixth St SW
Canton, OH 44710-1702

Mailing address

PO Box 80690
Canton, OH 44708-0690
Phone (330) 363-7444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121110000012 OH Practitioner - Nurse Practitioner 5395996821 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aultman North Canton Medical GroupGroup PAC ID 4082605266, 48 clinicians

Practice addresses (Care Compare)

2606 Wales Ave NW
Suite 200
Massillon, OH 44646-2394
Phone (330) 834-4725

Hospital & facility affiliations

  • Aultman Hospital Hospital, Canton, OH, CCN 360084
  • Aultman Orrville Hospital Hospital, Orrville, OH, CCN 361323

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
13853OHMDFamily Nurse Practitioner
13853-NPOHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Canton Aultman Emergency Physicians Inc Current Accepting new patients
Aultman Hospital CurrentSince Mar 20, 2020 Accepting new patients
Stark County Pathologists Inc Current Accepting new patients
Aultman North Canton Medical Group CurrentSince May 4, 2020 Accepting new patients
Aultman Hospital CurrentSince Mar 20, 2020 Accepting new patients
Ohio Physician Professional Corporation CurrentSince Oct 1, 2012 Accepting new patients
North Canton Medical Foundation Past Accepting new patients

Locations

2600 6th St SW
#6
Canton, OH 44710

2600 6th St SW
Canton, OH 44710
Phone (330) 363-2180

2600 7th St SW
Canton, OH 44710
Phone (330) 363-6242

2606 Wales Ave NW
Ste 200
Massillon, OH 44646
Phone (330) 833-8996

6046 Whipple Ave NW
#B
North Canton, OH 44720
Phone (330) 491-1670

6046 Whipple Ave NW
North Canton, OH 44720
Phone (330) 433-1200

6100 Whipple Ave NW
North Canton, OH 44720
Phone (330) 244-8778

Interoperability endpoints

  • Direct secure messaging: marcia.kiesling@direct.aultman.org

Organizations & group practices 7

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1348012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1497005334",
    "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": "447080690",
            "telephone_number": "330-363-7444",
            "fax_number": "330-363-7770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 SIXTH ST SW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447101702",
            "telephone_number": "330-363-6211",
            "fax_number": "330-580-5513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIESLING",
        "first_name": "MARCIA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-19",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "13853",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "13853-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.