Tracy Ann Kotnik, M.D., F.A.A.F.P.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

35062187K Issued in OH

Practice address

2859 Aaronwood Ave NE
Unit 3
Massillon, OH 44646-2371

Phone

(330) 832-2280

Fax

(330) 832-4732

NPI assigned

Oct 27, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278028800000",
    "number": "1619967957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3218 WOODRIDGE AVE NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447183448",
            "telephone_number": "330-456-5472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2859 AARONWOOD AVE NE",
            "address_2": "UNIT 3",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446462371",
            "telephone_number": "330-832-2280",
            "fax_number": "330-832-4732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTNIK",
        "first_name": "TRACY",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "M.D., F.A.A.F.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-27",
        "last_updated": "2010-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35062187K",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0936205",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Korosa, CNP
• Dorothea Ann Kostolich, RN
• Kothari Medical Associates, Inc.
• Rajnikant Kothari, MD
• Saroj Kothari, MD
• Eric M Kramer, CRNA
• Kron Dentistry, Inc.
• Gerald Philip Kron, DDS
• Kimberly Robeson Kron, DDS
• Syvanna A Krumlauf, LPN

• Family Medicine Physician in Massillon, OH
• Providers in Massillon, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.