Active NPI
Benjamin W. Falkenberg, AA
- Anesthesiologist Assistant
- Canton, OH
National Provider Identifier
1598048159
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiologist Assistant
- License
- 67.000187
- Practice address
- 4665 Douglas Cir NW
Suite 100
Canton, OH 44718-3673 - Phone
- (330) 656-3100
- NPI assigned
- Sep 21, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiologist Assistant | 367H00000X | 67.000187 | OH | Primary |
Addresses
Primary practice location
4665 Douglas Cir NW
Suite 100
Canton, OH 44718-3673
Mailing address
255 W Michigan Ave
PO Box 1123
Jackson, MI 49201-2218
Phone (517) 787-6440
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Associate of Arts
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316563200000",
"number": "1598048159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "255 W MICHIGAN AVE",
"address_2": "PO BOX 1123",
"city": "JACKSON",
"state": "MI",
"postal_code": "492012218",
"telephone_number": "517-787-6440",
"fax_number": "517-787-4146"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4665 DOUGLAS CIR NW",
"address_2": "SUITE 100",
"city": "CANTON",
"state": "OH",
"postal_code": "447183673",
"telephone_number": "330-656-3100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FALKENBERG",
"first_name": "BENJAMIN",
"middle_name": "W.",
"credential": "AA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-09-21",
"last_updated": "2011-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "367H00000X",
"taxonomy_group": "",
"desc": "Anesthesiologist Assistant",
"state": "OH",
"license": "67.000187",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.