Organization Active NPI

Atlantic Medical Group

  • Multi-Specialty Clinic/Center
  • Canton, OH
National Provider Identifier
1770968943
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
ATLANTIC MEDICAL GROUP
Practice address
2223 Fulton Rd NW Ste 102
Canton, OH 44709-3554
Phone
(330) 456-3487
Fax
(330) 456-3895
NPI assigned
Jul 29, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Authorized official

Name
Michelle Victoria Smith
Title
Office Manager
Phone
(330) 456-3487

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

2223 Fulton Rd NW Ste 102
Canton, OH 44709-3554

Mailing address

3501 Lesh St NE
Canton, OH 44705-4376
Phone (330) 456-3487

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170222002125 OH Part B Supplier - Clinic/Group Practice 0749564557 Receives reassigned benefits from 4 practitioners
Practice locations: Canton, OH

National Provider Directory

National Provider Directory

Locations

2223 Fulton Rd NW
Ste 102
Canton, OH 44709
Phone (330) 456-3487

Practitioners & affiliated clinicians

Practitioners 4

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": "1438128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744848000000",
    "number": "1770968943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 LESH ST NE",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447054376",
            "telephone_number": "330-456-3487",
            "fax_number": "330-456-3895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2223 FULTON RD NW STE 102",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447093554",
            "telephone_number": "330-456-3487",
            "fax_number": "330-456-3895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIC MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-29",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "VICTORIA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "330-456-3487"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Apr 17, 2025; 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.