NPIMap

Organization Active NPI

Austintown Pediatrics Inc

  • Pediatrics Physician
  • Youngstown, OH
National Provider Identifier
1841584356
Registry record updated Jun 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
AUSTINTOWN PEDIATRICS INC
Practice address
107 Javit CT
Youngstown, OH 44515-2442
Phone
(330) 797-0455
NPI assigned
Jun 1, 2011
Last updated
Jun 1, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2011

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

Authorized official

Name
Mr. Keith F Campanelli
Title
Practice Administrator
Phone
(330) 797-0455

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X Primary

Addresses

Primary practice location

107 Javit CT
Youngstown, OH 44515-2442

Mailing address

107 Javit CT
Youngstown, OH 44515-2442
Phone (330) 797-0455

Other identifiers 1

IdentifierTypeStateIssuer
2055065MedicaidOH

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D0342448Austintown Pediatrics Inc107 Javit Court, Austintown, OH 44515Certificate of waiverMar 31, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1306886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306886400000",
    "number": "1841584356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 JAVIT CT",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445152442",
            "telephone_number": "330-797-0455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 JAVIT CT",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445152442",
            "telephone_number": "330-797-0455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUSTINTOWN PEDIATRICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-01",
        "last_updated": "2011-06-01",
        "status": "A",
        "authorized_official_last_name": "CAMPANELLI",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "330-797-0455",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2055065",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.