Organization Active NPI

Holly J Maggiano MD Inc

  • Neurology Physician
  • Warren, OH
National Provider Identifier
1760782239
Registry record updated Oct 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
35065705 Issued in OH
Legal business name
HOLLY J MAGGIANO MD INC
Practice address
983 Niles Cortland Rd SE
Warren, OH 44484-2555
Phone
(330) 856-5003
Fax
(330) 856-9224
NPI assigned
Oct 29, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2010

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

Authorized official

Name
Holly J Maggiano, MDNPI 1104898493
Title
MD
Phone
(330) 856-5003

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X 35065705 OH Primary

Addresses

Primary practice location

983 Niles Cortland Rd SE
Warren, OH 44484-2555

Mailing address

983 Niles Cortland Rd SE
Warren, OH 44484-2555
Phone (330) 856-5003

Other identifiers 1

IdentifierTypeStateIssuer
0981737MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101214000312 OH Part B Supplier - Clinic/Group Practice 7012104250 Receives reassigned benefits from 1 practitioner
Practice locations: Warren, OH

National Provider Directory

National Provider Directory

Locations

8828 E Market St
Ste 2
Warren, OH 44484
Phone (330) 856-5003

8828 E Market St
Warren, OH 44484
Phone (330) 856-5003

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1288310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288310400000",
    "number": "1760782239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "983 NILES CORTLAND RD SE",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444842555",
            "telephone_number": "330-856-5003",
            "fax_number": "330-856-9224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "983 NILES CORTLAND RD SE",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444842555",
            "telephone_number": "330-856-5003",
            "fax_number": "330-856-9224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLLY J MAGGIANO MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-29",
        "last_updated": "2010-10-29",
        "status": "A",
        "authorized_official_last_name": "MAGGIANO",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "330-856-5003",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "OH",
            "license": "35065705",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0981737",
            "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 Oct 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.