NPIMap

Organization Active NPI

Kent State University

  • Rehabilitation Clinic/Center
  • Kent, OH
National Provider Identifier
1669994620
Registry record updated Jul 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
KENT STATE UNIVERSITY
Practice address
350 Midway Dr Macc Anx RM 123
Kent, OH 44242-0001
Phone
(330) 672-8426
NPI assigned
Jul 12, 2017
Last updated
Jul 12, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
KENT STATE UNIVERSITYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 12, 2017

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

Authorized official

Name
Julie A Volcheck
Title
Director
Phone
(330) 672-8194

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X NU Primary

Addresses

Primary practice location

350 Midway Dr Macc Anx RM 123
Kent, OH 44242-0001

Mailing address

1500 Eastway Dr
Kent, OH 44242-0001
Phone (330) 672-8194

Other names 1

  • Kent State University Sports Medicine Other name

National Provider Directory

National Provider Directory
Tax ID family
Kent State University Health Center5 organizations share this tax ID, including this one
Part of
Kent State University Health Center

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

350 Midway Dr Macc Anx
Rm 123
Kent, OH 44242
Phone (330) 672-8426

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1499817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1499817600000",
    "number": "1669994620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 EASTWAY DR",
            "city": "KENT",
            "state": "OH",
            "postal_code": "442420001",
            "telephone_number": "330-672-8194",
            "fax_number": "330-672-3711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 MIDWAY DR MACC ANX RM 123",
            "city": "KENT",
            "state": "OH",
            "postal_code": "442420001",
            "telephone_number": "330-672-8426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENT STATE UNIVERSITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KENT STATE UNIVERSITY",
        "enumeration_date": "2017-07-12",
        "last_updated": "2017-07-12",
        "status": "A",
        "authorized_official_last_name": "VOLCHECK",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "330-672-8194"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kent State University Sports Medicine",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Kent State University Sports Medicine",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Kent, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2017; 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.