Individual provider Active NPI

Kelly Marie Straub, PA-C

  • Physician Assistant
  • Canton, OH
National Provider Identifier
1720765233
Registry record updated Mar 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.009319RX Issued in OH
Practice address
2600 Sixth St. SW a-2
Ste 710
Canton, OH 44710
Phone
(330) 454-8076
Fax
(330) 454-3927
NPI assigned
Jun 28, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.009319RX OH Primary

Addresses

Primary practice location

2600 Sixth St. SW a-2
Ste 710
Canton, OH 44710

Mailing address

PO Box 80690
Canton, OH 44708-0690
Phone (330) 363-7444

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250331000396 OH Practitioner - Physician Assistant 0143743245 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aultman Deuble Heart and Vascular Hospital, LLCGroup PAC ID 1850726126, 109 clinicians

Practice addresses (Care Compare)

2037 Wales Ave NW
Suite 120
Massillon, OH 44646-4185
Phone (330) 454-8076

2600 6TH St SW
Canton, OH 44710-1702
Phone (330) 454-8076

6046 Whipple Ave NW
Canton, OH 44720-7616
Phone (330) 454-8076

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiovascular Consultants, Inc. Past Accepting new patients

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1687910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772409600000",
    "number": "1720765233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80690",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447080690",
            "telephone_number": "330-363-7444",
            "fax_number": "330-363-7770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 SIXTH ST. SW A-2",
            "address_2": "STE 710",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "44710",
            "telephone_number": "330-454-8076",
            "fax_number": "330-454-3927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STRAUB",
        "first_name": "KELLY",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-28",
        "last_updated": "2026-03-02",
        "certification_date": "2026-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.009319RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.