Organization Active NPI

Roberto Novoa, M.D., LLC

  • Specialist
  • Canton, OH
National Provider Identifier
1720107246
Registry record updated Oct 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
ROBERTO NOVOA, M.D., LLC
Practice address
2600 6TH St SW
Building a, Ste A2-110
Canton, OH 44710-1702
Phone
(330) 363-1341
Fax
(330) 363-0074
NPI assigned
Mar 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2016

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

Authorized official

Name
Roberto Novoa, MD
Title
Sole Proprietor
Phone
(330) 363-1341

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

2600 6TH St SW
Building a, Ste A2-110
Canton, OH 44710-1702

Mailing address

2600 Sixth Street SW
Suite A2-110
Canton, OH 44706-0329
Phone (330) 363-1341

Other identifiers 1

IdentifierTypeStateIssuer
0791353MedicaidOH

National Provider Directory

National Provider Directory

Locations

2600 6th St SW
Ste A2110
Canton, OH 44710
Phone (330) 363-1341

2600 6th St SW
Bldg A
Canton, OH 44710
Phone (330) 363-1341

4124 Munson St NW
Ste B
Canton, OH 44718
Phone (330) 363-1341

1320 Mercy Dr NW
Ste 101
Canton, OH 44708
Phone (330) 363-1341

Practitioners & affiliated clinicians

Practitioners 1

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": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477353600000",
    "number": "1720107246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 SIXTH STREET SW",
            "address_2": "SUITE A2-110",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447060329",
            "telephone_number": "330-363-1341",
            "fax_number": "330-363-0074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 6TH ST SW",
            "address_2": "BUILDING A, STE A2-110",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447101702",
            "telephone_number": "330-363-1341",
            "fax_number": "330-363-0074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERTO NOVOA, M.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2016-10-25",
        "status": "A",
        "authorized_official_last_name": "NOVOA",
        "authorized_official_first_name": "ROBERTO",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "330-363-1341",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0791353",
            "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 Oct 25, 2016; 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.