Active NPI
Foundation Health Care, Inc.
- Family Medicine Physician
- Youngstown, OH
National Provider Identifier
1619090891
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- FOUNDATION HEALTH CARE, INC.
- Practice address
- 755 Boardman-Canfiled Road
Suite F5
Youngstown, OH 44514 - Phone
- (330) 726-3806
- Fax
- (330) 726-9450
- NPI assigned
- Apr 10, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Michael B Evan, MD
- Title
- President
- Phone
- (330) 707-1425
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
755 Boardman-Canfiled Road
Suite F5
Youngstown, OH 44514
Mailing address
6615 Clingan Rd
Suite D
Poland, OH 44514-2196
Phone (330) 707-1425
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| FO9371331 | Other | OH | PTAN |
| 1083828974 | Other | NPI | |
| 1467436261 | Other | NPI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
Other NPIs on the same Medicare enrollment 2
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider DirectoryLocations
6615 Clingan Rd
Ste D
Youngstown, OH 44514
Phone (330) 707-1425
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- Boardman, OH
- NPI 1467436261
-
- Internal Medicine Physician
- Youngstown, OH
- NPI 1073597472
-
- Internal Medicine Physician
- Poland, OH
- NPI 1588630404
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176163200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1202688000000",
"number": "1619090891",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6615 CLINGAN RD",
"address_2": "SUITE D",
"city": "POLAND",
"state": "OH",
"postal_code": "445142196",
"telephone_number": "330-707-1425",
"fax_number": "330-757-2814"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "755 BOARDMAN-CANFILED ROAD",
"address_2": "SUITE F5",
"city": "YOUNGSTOWN",
"state": "OH",
"postal_code": "44514",
"telephone_number": "330-726-3806",
"fax_number": "330-726-9450"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FOUNDATION HEALTH CARE, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2007-04-10",
"last_updated": "2008-02-11",
"status": "A",
"authorized_official_last_name": "EVAN",
"authorized_official_first_name": "MICHAEL",
"authorized_official_middle_name": "B",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "330-707-1425",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PTAN",
"identifier": "FO9371331",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1083828974",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1467436261",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Youngstown, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.