NPIMap

Organization Active NPI

Ear,Nose and Throat of Warren, Inc.

  • Otolaryngology Physician
  • Warren, OH
National Provider Identifier
1740436641
Registry record updated Jul 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
35.091822 Issued in OH
Legal business name
EAR,NOSE AND THROAT OF WARREN, INC.
Practice address
628 Niles Cortland Rd SE
Suite 103
Warren, OH 44484-2473
Phone
(330) 609-8430
Fax
(133) 031-5753
NPI assigned
Aug 11, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2009

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

Authorized official

Name
Ewain Wilson, M.D.
Title
Director
Phone
(330) 609-8430

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X 35.091822 OH Primary

Addresses

Primary practice location

628 Niles Cortland Rd SE
Suite 103
Warren, OH 44484-2473

Mailing address

628 Niles Cortland Rd SE
Suite 103
Warren, OH 44484-2473
Phone (330) 609-8430

Other identifiers 1

IdentifierTypeStateIssuer
00000579715OtherOHANTHEM

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1218412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248134400000",
    "number": "1740436641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "628 NILES CORTLAND RD SE",
            "address_2": "SUITE 103",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444842473",
            "telephone_number": "330-609-8430",
            "fax_number": "133-031-5754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "628 NILES CORTLAND RD SE",
            "address_2": "SUITE 103",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444842473",
            "telephone_number": "330-609-8430",
            "fax_number": "133-031-5753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAR,NOSE AND THROAT OF WARREN, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-11",
        "last_updated": "2009-07-21",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "EWAIN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "330-609-8430",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "OH",
            "license": "35.091822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "00000579715",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2009; 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.