Individual provider Active NPI

Susan Hake, MD

  • Family Medicine Physician
  • North Canton, OH
National Provider Identifier
1558325373
Registry record updated Feb 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0664902 Issued in OH
Practice address
6512 Whipple Ave NW
North Canton, OH 44720-7340
Phone
(330) 499-5600
NPI assigned
Apr 17, 2006
Last updated
Feb 26, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0664902 OH Primary

Addresses

Primary practice location

6512 Whipple Ave NW
North Canton, OH 44720-7340

Mailing address

6512 Whipple Ave NW
North Canton, OH 44720-7340
Phone (330) 499-5600

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101012001434 OH Practitioner - Family Practice 5092887828 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wright State University Boonshoft School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2600 6TH St SW
Canton, OH 44710-1702
Phone (330) 438-6333

6512 Whipple Ave NW
North Canton, OH 44720-7340
Phone (330) 449-5600

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0664902OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aultman North Canton Medical Group CurrentSince Jul 1, 2017 Accepting new patients
Ohio Physician Professional Corporation CurrentSince Aug 1, 2010 Accepting new patients
North Canton Medical Foundation Past Accepting new patients

Locations

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

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

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

6512 Whipple Ave NW
North Canton, OH 44720
Phone (330) 497-3727

Interoperability endpoints

  • Direct secure messaging: susan.hake@direct.aultman.org

Organizations & group practices 3

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

Hospital & facility affiliations 4

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": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235606400000",
    "number": "1558325373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6512 WHIPPLE AVE NW",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447207340",
            "telephone_number": "330-499-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6512 WHIPPLE AVE NW",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447207340",
            "telephone_number": "330-499-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAKE",
        "first_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-17",
        "last_updated": "2009-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "0664902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Canton, OH

Sources for this page

Verify at the official NPI Registry.