Organization Active NPI

Stark Family Health Center

  • Family Medicine Physician
  • Canton, OH
National Provider Identifier
1780797365
Registry record updated Mar 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
STARK FAMILY HEALTH CENTER
Practice address
4465 Fulton Dr NW Ste 100
Canton, OH 44718-2851
Phone
(330) 497-2700
NPI assigned
Aug 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2008

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

Authorized official

Name
Rita Michelle Swisher
Title
Office Manager
Phone
(330) 497-2700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

4465 Fulton Dr NW Ste 100
Canton, OH 44718-2851

Mailing address

4465 Fulton Dr NW Ste 100
Canton, OH 44718-2851
Phone (330) 497-2700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050112000002 OH Part B Supplier - Clinic/Group Practice 6608824016 Receives reassigned benefits from 1 practitioner
Practice locations: Canton, OH

National Provider Directory

National Provider Directory
Tax ID family
Stark Family Health Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

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": "1155686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204502400000",
    "number": "1780797365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4465 FULTON DR NW STE 100",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182851",
            "telephone_number": "330-497-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4465 FULTON DR NW STE 100",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182851",
            "telephone_number": "330-497-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STARK FAMILY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-16",
        "last_updated": "2008-03-03",
        "status": "A",
        "authorized_official_last_name": "SWISHER",
        "authorized_official_first_name": "RITA",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "330-497-2700"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "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 Mar 3, 2008; 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.