Marybeth Kathleen Hannum, APRN-PC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

.025045 Issued in OH

Practice address

6076 Whipple Ave NW
North Canton, OH 44720-7616

Phone

(330) 433-1777

Fax

(330) 305-5001

NPI assigned

Jul 7, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Children'S Hospital Medical Center of Akron

  • Pediatrics Physician
  • Akron, OH
  • NPI 1841328853
  Medicare reassignment NPD
• Akron Children'S Hospital

  • Children's Hospital
  • Akron, OH
  • NPI 1942465752
  NPD
• Children'S Hospital Medical Center of Akron

  • Anesthesiology Physician
  • Boardman, OH
  • NPI 1417257601
  NPD
• Children'S Hospital Medical Center of Akron

  • Home Infusion Agency
  • Akron, OH
  • NPI 1649485848
  NPD

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

{
    "created_epoch": "1562457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614038400000",
    "number": "1720640089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6076 WHIPPLE AVE NW",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447207616",
            "telephone_number": "330-433-1777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6076 WHIPPLE AVE NW",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447207616",
            "telephone_number": "330-433-1777",
            "fax_number": "330-305-5001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNUM",
        "first_name": "MARYBETH",
        "middle_name": "KATHLEEN",
        "name_prefix": "Mrs.",
        "credential": "APRN-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-07",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OH",
            "license": ".025045",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": ".025045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mhannum9759@direct.chmca.org",
            "affiliation": "N",
            "address_1": "6076 Whipple Ave NW",
            "city": "North Canton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "447207616",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Monica Haney
• Sean Haney
• Carl Hankison, PTA
• Michael K Hanna, LPTA
• Tristopher A Hanning, LPN
• Erik Hansel, COTA
• Laurie Hanson, LPTA
• Darlene A Harden, COTA/L
• Nicole M Harden, OTR/L
• Stephanie Harding, DMD

• Nurse Practitioner in North Canton, OH
• Providers in North Canton, OH by specialty
• Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 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.

Verify at the official NPI Registry.