Individual provider Active NPI

David P Gutlove, MD

  • Anesthesiology Physician
  • Canton, OH
National Provider Identifier
1639129778
Registry record updated Nov 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
35069673 Issued in OH
Practice address
1320 Mercy Dr NW
Canton, OH 44708-2614
Phone
(330) 489-1478
Fax
(330) 430-2717
NPI assigned
May 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 35069673 OH Primary

Addresses

Primary practice location

1320 Mercy Dr NW
Canton, OH 44708-2614

Mailing address

1320 Mercy Dr NW
Canton, OH 44708-2614
Phone (330) 489-1478

Other identifiers 3

IdentifierTypeStateIssuer
050062421OtherMEDICARE RAILROAD
000000135911OtherANTHEM
0215798MedicaidOH

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090209000464 OH Practitioner - Pain Management 7911062997 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35069673OHMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Professional Care, LLC Anesthesiology CurrentSince Jan 1, 2009 Accepting new patients
Stark County Anesthesia, Inc. Anesthesiology Past Accepting new patients

Locations

1330 Mercy Dr NW
Ste 319
Canton, OH 44708
Phone (330) 580-4706

1330 Timken Mercy Dr NW
Ste 302
Canton, OH 44708
Phone (330) 489-1498

4665 Douglas Cir NW
Ste 101
Canton, OH 44718
Phone (330) 499-5700

1320 Timken Mercy Dr NW
Canton, OH 44708
Phone (330) 489-1000

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288915200000",
    "number": "1639129778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 MERCY DR NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447082614",
            "telephone_number": "330-489-1478",
            "fax_number": "330-430-2717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 MERCY DR NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447082614",
            "telephone_number": "330-489-1478",
            "fax_number": "330-430-2717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTLOVE",
        "first_name": "DAVID",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2010-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OH",
            "license": "35069673",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "050062421",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000135911",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0215798",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.