Jonathan Simon Fain, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

35063392 Issued in OH

Practice address

335 Glessner Ave
Pathology Department
Mansfield, OH 44903-2269

Phone

(419) 526-8509

Fax

(419) 520-2846

NPI assigned

Jan 18, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395792000000",
    "number": "1790837615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 SOUTHWYCK BLVD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436141509",
            "telephone_number": "800-288-8325",
            "fax_number": "419-866-5453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 GLESSNER AVE",
            "address_2": "PATHOLOGY DEPARTMENT",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449032269",
            "telephone_number": "419-526-8509",
            "fax_number": "419-520-2846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIN",
        "first_name": "JONATHAN",
        "middle_name": "SIMON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2014-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "OH",
            "license": "35063392",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0881149",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Uchenna A Ezike, M.D
• Ralph Barnal Facio Jr.
• Anthony Nabil Fahmy, M.D.
• Katherine Failor, LISW-S
• Erin Beirne Fain, M.D.
• Matthew Lee Fair, PA-C
• Marquita L Fairchild
• Patricia Helen Fairtile, C.R.N.A.
• Lexus Falde
• Anna Catherine Falls, DO

• Anatomic Pathology & Clinical Pathology Physician in Mansfield, OH
• Providers in Mansfield, OH by specialty
• Anatomic Pathology & Clinical Pathology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.