Active NPI
Joseph R Cordova, MD
- Family Medicine Physician
- Niles, OH
National Provider Identifier
1710974027
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 35072593C
- Practice address
- 1254 Youngstown Warren Rd
Ste 3a
Niles, OH 44446-4612 - Phone
- (330) 652-3000
- Fax
- (330) 652-3008
- NPI assigned
- Oct 3, 2005
- Last updated
- May 8, 2008
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 35072593C | OH | Primary |
Addresses
Primary practice location
1254 Youngstown Warren Rd
Ste 3a
Niles, OH 44446-4612
Mailing address
1254 Youngstown Warren Rd
Ste 3a
Niles, OH 44446-4612
Phone (330) 652-3000
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00080212 | Other | OH | RAILROAD MEDICARE |
| CO0847326 | Other | OH | MEDICARE ID |
| 2141444 | Medicaid | OH |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35072593C | OH | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lima Memorial Joint Operating Company | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Lima Memorial Health System
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210204800000",
"number": "1710974027",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1254 YOUNGSTOWN WARREN RD",
"address_2": "STE 3A",
"city": "NILES",
"state": "OH",
"postal_code": "444464612",
"telephone_number": "330-652-3000",
"fax_number": "330-652-3008"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1254 YOUNGSTOWN WARREN RD",
"address_2": "STE 3A",
"city": "NILES",
"state": "OH",
"postal_code": "444464612",
"telephone_number": "330-652-3000",
"fax_number": "330-652-3008"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORDOVA",
"first_name": "JOSEPH",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-03",
"last_updated": "2008-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OH",
"license": "35072593C",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00080212",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE ID",
"identifier": "CO0847326",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2141444",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Niles, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.