Individual provider Active NPI

Lori Ann Marietta, ACNS

  • Adult Health Clinical Nurse Specialist
  • North Canton, OH
National Provider Identifier
1760788053
Registry record updated Feb 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Clinical Nurse SpecialistTaxonomy code 364SA2200X
License
11388-NS Issued in OH
Practice address
6100 Whipple Ave NW
North Canton, OH 44720-7618
Phone
(330) 244-8118
Fax
(330) 244-8329
NPI assigned
Feb 3, 2011
Last updated
Feb 12, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Clinical Nurse Specialist 364SA2200X 11388-NS OH Primary
Registered Nurse 163W00000X 259463 OH

Addresses

Primary practice location

6100 Whipple Ave NW
North Canton, OH 44720-7618

Mailing address

6100 Whipple Ave NW
North Canton, OH 44720-7618
Phone (330) 244-8118

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
I20110505000382 OH Practitioner - Certified Clinical Nurse Specialist (CNS) 4981889060 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Clinical Nurse Specialist (CNS)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2051 Wales Ave NW
Massillon, OH 44646-2393
Phone (330) 363-7462

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.62 of 100Reported as group
Quality
77.5
Promoting interoperability
100
Improvement activities
40
Cost
74.58

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist

State licenses

LicenseStateTypeSpecialty
259463OHMDRegistered Nurse
11388-NSOHMDAdult Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Ohio Hospital-Based Physician Corporation CurrentSince Aug 3, 2020 Accepting new patients
Aultman Hospital Current Accepting new patients
Ohio Hospital-Based Physicians Corporation CurrentSince Aug 3, 2020 Accepting new patients

Locations

2600 6th St SW
Canton, OH 44710
Phone (330) 363-2180

2051 Wales Ave NW
Massillon, OH 44646
Phone (330) 363-7462

6100 Whipple Ave NW
North Canton, OH 44720
Phone (330) 305-6999

832 S Main St
Orrville, OH 44667
Phone (330) 456-2695

Interoperability endpoints

  • Direct secure messaging: lori.marietta@direct.aultman.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1296691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518393600000",
    "number": "1760788053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 WHIPPLE AVE NW",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447207618",
            "telephone_number": "330-244-8118",
            "fax_number": "330-244-8329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6100 WHIPPLE AVE NW",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447207618",
            "telephone_number": "330-244-8118",
            "fax_number": "330-244-8329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARIETTA",
        "first_name": "LORI",
        "middle_name": "ANN",
        "credential": "ACNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-03",
        "last_updated": "2018-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "OH",
            "license": "11388-NS",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "259463",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Canton, OH

Sources for this page

Verify at the official NPI Registry.