Individual provider Active NPI

Juanita Thompson-Quattlebaum, MD

  • Student in an Organized Health Care Education/Training Program
  • Canton, OH
National Provider Identifier
1609704949
Registry record updated May 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
57.260699 Issued in OH
Practice address
2600 7TH St SW
Canton, OH 44710-1801
Phone
(330) 363-4922
Fax
(330) 363-4914
NPI assigned
May 8, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 57.260699 OH Primary

Addresses

Primary practice location

2600 7TH St SW
Canton, OH 44710-1801

Mailing address

2600 7TH St SW
Canton, OH 44710-1801
Phone (330) 363-4922

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57.260699OHMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1778198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778198400000",
    "number": "1609704949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 7TH ST SW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447101801",
            "telephone_number": "330-363-4922",
            "fax_number": "330-363-4914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 7TH ST SW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447101801",
            "telephone_number": "330-363-4922",
            "fax_number": "330-363-4914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON-QUATTLEBAUM",
        "first_name": "JUANITA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-05-08",
        "last_updated": "2026-05-08",
        "certification_date": "2026-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": "57.260699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.