Active NPI
Marvis R Dockus, LPN
- Licensed Practical Nurse
- Canton, OH
National Provider Identifier
1730358144
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- LPN.082491-MEDS
- Practice address
- 2600 Sixth St SW FL 6
Canton, OH 44710-1702 - Phone
- (330) 830-3393
- Fax
- (234) 521-7091
- NPI assigned
- Feb 29, 2008
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | LPN.082491-MEDS | OH | Primary |
Addresses
Primary practice location
2600 Sixth St SW FL 6
Canton, OH 44710-1702
Mailing address
1341 Market Ave N
Canton, OH 44714-2605
Phone (330) 453-8252
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0182326 | 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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPN.082491-MEDS | OH | MD | Licensed Practical Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Commquest Services, Inc. | 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 and National Provider Directory roles.
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Canton, OH
- NPI 1841550696
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1204243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640736000000",
"number": "1730358144",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1341 MARKET AVE N",
"city": "CANTON",
"state": "OH",
"postal_code": "447142605",
"telephone_number": "330-453-8252",
"fax_number": "330-453-6716"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2600 SIXTH ST SW FL 6",
"city": "CANTON",
"state": "OH",
"postal_code": "447101702",
"telephone_number": "330-830-3393",
"fax_number": "234-521-7091"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOCKUS",
"first_name": "MARVIS",
"middle_name": "R",
"credential": "LPN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-02-29",
"last_updated": "2021-12-29",
"certification_date": "2021-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "OH",
"license": "LPN.082491-MEDS",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0182326",
"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 Dec 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.