Family Medical Clinic & Laser Skin Solutions

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN222488-COA1 Issued in OH

Legal business name

FAMILY MEDICAL CLINIC & LASER SKIN SOLUTIONS

Practice address

905 N 21St St
Newark, OH 43055-7251

Phone

(740) 323-3427

NPI assigned

Aug 13, 2012

Organization subpart

No

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

Authorized official

Name

John Gardner, CNP

Title

CNP

Phone

(740) 323-3427

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1344816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344816000000",
    "number": "1841547593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8781 SOMERSET RD",
            "city": "THORNVILLE",
            "state": "OH",
            "postal_code": "430769390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 N 21ST ST",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430557251",
            "telephone_number": "740-323-3427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY MEDICAL CLINIC & LASER SKIN SOLUTIONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-13",
        "last_updated": "2012-08-13",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CNP",
        "authorized_official_telephone_number": "740-323-3427",
        "authorized_official_credential": "CNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "RN222488-COA1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donald J Fairbanks, MD
• Kasey Faller
• Family & Youth Institute
• Family Focus Home Health, LLC
• Family Health Services of East Central Ohio, Inc.
• Deborrah G Fancher, CNP
• Gabrielle Alicia Farkas, D.O.
• Diana Farmer
• Raju Fatehchand, MD FACP
• Connor Fee

• Family Nurse Practitioner in Newark, OH
• Providers in Newark, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.