Active NPI
Michael Charles Reardon
- Prevention Professional
- Akron, OH
National Provider Identifier
1699559385
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prevention Professional
- License
- RA.163682
- Practice address
- 370 E Market St
Akron, OH 44304-1526 - Phone
- (330) 535-3263
- NPI assigned
- Aug 23, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prevention Professional | 405300000X | RA.163682 | OH | Primary |
Addresses
Primary practice location
370 E Market St
Akron, OH 44304-1526
Mailing address
2964 Work Rd
Ravenna, OH 44266-8324
Phone (234) 263-8036
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RA.163682 | OH | MD | Prevention Professional |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1692748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692748800000",
"number": "1699559385",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2964 WORK RD",
"city": "RAVENNA",
"state": "OH",
"postal_code": "442668324",
"telephone_number": "234-263-8036"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "370 E MARKET ST",
"city": "AKRON",
"state": "OH",
"postal_code": "443041526",
"telephone_number": "330-535-3263"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REARDON",
"first_name": "MICHAEL",
"middle_name": "CHARLES",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-08-23",
"last_updated": "2023-08-23",
"certification_date": "2023-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "405300000X",
"taxonomy_group": "",
"desc": "Prevention Professional",
"state": "OH",
"license": "RA.163682",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Akron, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.