Active NPI
Nicholas Bloxsom
- Counselor
- Akron, OH
National Provider Identifier
1700458726
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- C2002866-T
- Practice address
- 640 W Market St
Akron, OH 44303-1465 - Phone
- (330) 762-5425
- NPI assigned
- Jul 12, 2021
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | C2002866-T | OH | Primary |
Addresses
Primary practice location
640 W Market St
Akron, OH 44303-1465
Mailing address
640 W Market St
Akron, OH 44303-1465
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| C2002866-T | Other | OH | COUNSELOR IN TRAINING |
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: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C2002866-T | OH | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Coleman Professional Services, Inc. | Current | Accepting new patients |
Locations
2421 13th St NW
Canton, OH 44708
Phone (330) 452-6000
2600 6th St SW
Canton, OH 44710
Phone (330) 363-2180
624 Market Ave N
Canton, OH 44702
Phone (330) 454-7066
5982 Rhodes Rd
Kent, OH 44240
Phone (330) 676-6875
Organizations & group practices 1
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1626048000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626048000000",
"number": "1700458726",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "640 W MARKET ST",
"city": "AKRON",
"state": "OH",
"postal_code": "443031465"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "640 W MARKET ST",
"city": "AKRON",
"state": "OH",
"postal_code": "443031465",
"telephone_number": "330-762-5425"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLOXSOM",
"first_name": "NICHOLAS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-07-12",
"last_updated": "2021-07-12",
"certification_date": "2021-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "OH",
"license": "C2002866-T",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COUNSELOR IN TRAINING",
"identifier": "C2002866-T",
"state": "OH"
}
],
"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 Jul 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.