Individual provider Active NPI

Christine Pillitiere

  • Psychiatric/Mental Health Nurse Practitioner
  • Canton, OH
National Provider Identifier
1669253845
Registry record updated Sep 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN.CNP.0032841 Issued in OH
Practice address
4641 Fulton Dr NW
Canton, OH 44718-2384
Phone
(330) 454-7917
NPI assigned
Oct 12, 2023
Last updated
Sep 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN.CNP.0032841 OH Primary

Addresses

Primary practice location

4641 Fulton Dr NW
Canton, OH 44718-2384

Mailing address

4641 Fulton Dr NW
Canton, OH 44718-2384
Phone (330) 454-7917

Other practice location 1

258 Brookledge Ln
Copley, OH 44321-3240
Phone (330) 217-8272

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240127000645 OH Practitioner - Nurse Practitioner 7719330562 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
360Team Psychiatry LLC Psychiatric/Mental Health CurrentSince Feb 15, 2024 Accepting new patients
Child and Adolescent Behavioral Health CurrentSince Jan 5, 2024 Accepting new patients
Child and Adolescent Behavioral Health Past Accepting new patients

Locations

12910 Shelbyville Rd
Ste 300
Louisville, KY 40243
Phone (502) 214-0693

405 S Linden Ave
Alliance, OH 44601
Phone (330) 433-6075

1801 Schneider St NE
Canton, OH 44721
Phone (330) 454-7917

4641 Fulton Dr NW
Canton, OH 44718
Phone (330) 433-6075

919 2nd St NE
Canton, OH 44704
Phone (330) 454-7917

740 Commerce Dr
Ste A
Perrysburg, OH 43551
Phone 24852821166

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1697068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1669253845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4641 FULTON DR NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182384",
            "telephone_number": "330-454-7917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4641 FULTON DR NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182384",
            "telephone_number": "330-454-7917"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "258 Brookledge Ln",
            "address_purpose": "LOCATION",
            "city": "Copley",
            "state": "OH",
            "postal_code": "443213240",
            "country_code": "US",
            "telephone_number": "330-217-8272",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PILLITIERE",
        "first_name": "CHRISTINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-12",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.0032841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.