NPIMap

Organization Active NPI

Mercy Health Youngstown LLC

  • Internal Medicine Physician
  • Warren, OH
National Provider Identifier
1497920409
Registry record updated Jan 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MERCY HEALTH YOUNGSTOWN LLC
Practice address
667 Eastland Ave SE
Warren, OH 44484-4503
Phone
(330) 841-4000
NPI assigned
Apr 30, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2022

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

Authorized official

Name
Matthew A. Love
Title
Cfo
Phone
(330) 884-7055

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

667 Eastland Ave SE
Warren, OH 44484-4503

Mailing address

667 Eastland Ave SE
Warren, OH 44484-4503
Phone (330) 841-4000

Other identifiers 1

IdentifierTypeStateIssuer
0942494MedicaidOH

Other names 1

  • SJHC Physician Group Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1209513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643155200000",
    "number": "1497920409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "667 EASTLAND AVE SE",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444844503",
            "telephone_number": "330-841-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "667 EASTLAND AVE SE",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444844503",
            "telephone_number": "330-841-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY HEALTH YOUNGSTOWN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-30",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-26",
        "status": "A",
        "authorized_official_last_name": "LOVE",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "330-884-7055"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0942494",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SJHC Physician Group",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "SJHC Physician Group",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Jan 26, 2022; 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.