Active NPI
Doug Sposetta
- Family Nurse Practitioner
- Austintown, OH
National Provider Identifier
1598131237
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- COA.17880-NP
- Practice address
- 1450 S Canfield Niles Rd
Austintown, OH 44515-4085 - Phone
- (330) 799-8752
- Fax
- (330) 799-8754
- NPI assigned
- Aug 17, 2015
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | COA.17880-NP | OH | Primary |
Addresses
Primary practice location
1450 S Canfield Niles Rd
Austintown, OH 44515-4085
Mailing address
1450 S Canfield Niles Rd
Austintown, OH 44515-4085
Phone (330) 799-8752
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 17880-NP | Other | OH | OHIO BOARD OF NURSING CREDENTIAL NUMBER |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| COA.17880-NP | OH | MD | Family Nurse Practitioner |
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Youngstown, OH
- NPI 1184761405
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1439769600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1457049600000",
"number": "1598131237",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1450 S CANFIELD NILES RD",
"city": "AUSTINTOWN",
"state": "OH",
"postal_code": "445154085",
"telephone_number": "330-799-8752",
"fax_number": "330-799-8754"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1450 S CANFIELD NILES RD",
"city": "AUSTINTOWN",
"state": "OH",
"postal_code": "445154085",
"telephone_number": "330-799-8752",
"fax_number": "330-799-8754"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPOSETTA",
"first_name": "DOUG",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-08-17",
"last_updated": "2016-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "OH",
"license": "COA.17880-NP",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OHIO BOARD OF NURSING CREDENTIAL NUMBER",
"identifier": "17880-NP",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Austintown, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.