Individual

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

Legal business name

INDIVIDUAL

Practice address

1111 Gonder Avenue SE
Canton, OH 44707

Phone

(330) 209-0732

NPI assigned

Sep 30, 2016

Organization subpart

No

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

Authorized official

Name

Miss Tammie Lynn Mayle

Title

Home Health Aid

Phone

(330) 209-0732

Specialties & licenses 1

Addresses

Tax ID family

Individual2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Individual

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Canton, OH
  • NPI 1962958512
  NPD tax ID

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

{
    "created_epoch": "1475193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475193600000",
    "number": "1720537780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 GONDER AVE SE",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447073321",
            "telephone_number": "330-209-0732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 GONDER AVENUE SE",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "44707",
            "telephone_number": "330-209-0732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIVIDUAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-30",
        "last_updated": "2016-09-30",
        "status": "A",
        "authorized_official_last_name": "MAYLE",
        "authorized_official_first_name": "TAMMIE",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "HOME HEALTH AID",
        "authorized_official_telephone_number": "330-209-0732",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ideal Vision LLC
• Philip H Iffland, D.D.S.
• James E Ijoma, CSP
• Cristina Dawn Ilijevski, APRN-CNP
• Imprinting LLC
• Individual
• Amy Indorf, MD
• Infusion Partners, LLC
• Amita Ingale
• Deeana Renee Ingol

• Preferred Provider Organization in Canton, OH
• Providers in Canton, OH by specialty
• Preferred Provider Organization in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 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.