Canton Internal Medicine Associates Ince

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

OH35060119 Issued in OH

Legal business name

CANTON INTERNAL MEDICINE ASSOCIATES INCE

Practice address

4076 Holiday St NW
Canton, OH 44718

Phone

(330) 492-3738

Fax

(330) 492-5640

NPI assigned

Jun 9, 2006

Organization subpart

No

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

Authorized official

Name

Stacy Lynn Diehl

Title

Insurance Claims Processor

Phone

(330) 833-5692

Specialties & licenses 1

Addresses

Other identifiers 1

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

CLIA laboratory certificates

Locations

Practitioners 2

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

• Eser Talug, MD

  • Internal Medicine Physician
  • Canton, OH
  • NPI 1255322913
  NPD
• Carmen Gabriela Kelling, MD

  • Internal Medicine Physician
  • Bothell, WA
  • NPI 1457300543
  NPD (past)

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1518908698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4076 HOLIDAY ST NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "44718",
            "telephone_number": "330-492-3738",
            "fax_number": "330-492-5640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4076 HOLIDAY ST NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "44718",
            "telephone_number": "330-492-3738",
            "fax_number": "330-492-5640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANTON INTERNAL MEDICINE ASSOCIATES INCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DIEHL",
        "authorized_official_first_name": "STACY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "INSURANCE CLAIMS PROCESSOR",
        "authorized_official_telephone_number": "330-833-5692"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "OH35060119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0792898",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Canton Family Dentistry
• Canton Family Healthcare LLC
• Canton Friendship Center, Inc.
• Canton General Surgery Associates, Inc.
• Canton Injury Center LLC
• Canton Ophthalmology Associates, Inc.
• Canton Orthotic Laboratory Inc
• Canton Pathology Associates, Inc.
• Canton Pediatric Dental Center
• Canton Primary Care & Hospital Medicine, Inc..

• Internal Medicine Physician in Canton, OH
• Providers in Canton, OH by specialty
• Internal Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.