Individual provider Active NPI

Alyssa Glover, D.O.

  • Diagnostic Radiology Physician
  • Canton, OH
National Provider Identifier
1700270089
Registry record updated Sep 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
34.015297 Issued in OH
Practice address
2600 6TH St SW
Canton, OH 44710-1702
Phone
(330) 363-2842
NPI assigned
Mar 24, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Diagnostic Radiology Physician 2085R0202X 34.015297 OH Primary

Addresses

Primary practice location

2600 6TH St SW
Canton, OH 44710-1702

Mailing address

272 Hospital Rd
Chillicothe, OH 45601-9031

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
I20211008000788 OH Practitioner - Diagnostic Radiology 1456656610 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Lake Erie College of Osteopathic Medicine, Erie, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mori Bean and Brooks IncGroup PAC ID 8820077878, 966 clinicians

Practice addresses (Care Compare)

9667 Riverway Run
Powell, OH 43065-8374
Phone (904) 399-5550

Merit-based Incentive Payment System (MIPS)

Final score
78.06 of 100Reported as group
Quality
72.79
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34.015297OHMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Radiology Associates of Canton, Inc. Diagnostic Radiology CurrentSince Oct 1, 2021 Accepting new patients
Radiology Associates of Canton, Inc Diagnostic Radiology CurrentSince Oct 1, 2021 Accepting new patients
Mori Bean and Brooks Inc Diagnostic Radiology CurrentSince May 16, 2024 Accepting new patients
Mountain Radiology, Inc Diagnostic Radiology Past Accepting new patients
Columbus Radiology Corp Diagnostic Radiology PastSince Dec 4, 2021 Accepting new patients

Locations

2600 6th St SW
Canton, OH 44710
Phone (330) 363-2180

1020 Trump Rd NW
Carrollton, OH 44615
Phone (330) 627-0091

6100 Whipple Ave NW
North Canton, OH 44720
Phone (330) 244-8778

832 S Main St
Orrville, OH 44667
Phone (330) 456-2695

Organizations & group practices 5

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": "1427155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631750400000",
    "number": "1700270089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "272 HOSPITAL RD",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456019031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 6TH ST SW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447101702",
            "telephone_number": "330-363-2842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLOVER",
        "first_name": "ALYSSA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-24",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "34.015297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.