Organization Active NPI

Arthritis Clinic of Stark County Inc.

  • Rheumatology Physician
  • Canton, OH
National Provider Identifier
1710083332
Registry record updated Jan 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
Legal business name
ARTHRITIS CLINIC OF STARK COUNTY INC.
Practice address
4160 Holiday St NW
Canton, OH 44718-2532
Phone
(330) 492-4966
Fax
(330) 429-9344
NPI assigned
Sep 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2011

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

Authorized official

Name
Mrs. Debbbie J Mallernee
Title
Office Manager
Phone
(330) 492-4966

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RR0500X Primary

Addresses

Primary practice location

4160 Holiday St NW
Canton, OH 44718-2532

Mailing address

4160 Holiday St NW
Canton, OH 44718-2532
Phone (330) 492-4966

Other identifiers 1

IdentifierTypeStateIssuer
0576747MedicaidOH

National Provider Directory

National Provider Directory

Locations

4565 Dressler Rd NW
Ste 101
Canton, OH 44718
Phone (216) 492-4966

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294185600000",
    "number": "1710083332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4160 HOLIDAY ST NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182532",
            "telephone_number": "330-492-4966",
            "fax_number": "330-429-9344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4160 HOLIDAY ST NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182532",
            "telephone_number": "330-492-4966",
            "fax_number": "330-429-9344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARTHRITIS CLINIC OF STARK COUNTY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-15",
        "last_updated": "2011-01-05",
        "status": "A",
        "authorized_official_last_name": "MALLERNEE",
        "authorized_official_first_name": "DEBBBIE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "330-492-4966",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0576747",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2011; 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.