NPIMap

Organization Active NPI

Innovative Wound Care Associates, Inc

  • Vascular Surgery Physician
  • Boardman, OH
National Provider Identifier
1881035343
Registry record updated Jul 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
3951291 Issued in PA
Legal business name
INNOVATIVE WOUND CARE ASSOCIATES, INC
Practice address
790 Boardman Canfield Rd Ste 3
Boardman, OH 44512-4344
Phone
(866) 758-4862
Fax
(330) 758-4886
NPI assigned
Jul 12, 2013
Last updated
Jul 17, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2013

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

Authorized official

Name
John P BalkoNPI 1932104742
Title
Director
Phone
(724) 347-0591

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X OH
Vascular Surgery Physician 2086S0129X 3951291 PA Primary

Addresses

Primary practice location

790 Boardman Canfield Rd Ste 3
Boardman, OH 44512-4344

Mailing address

100 N Keel Ridge Rd
Hermitage, PA 16148-3440
Phone (800) 471-8592

Other names 1

  • Nature-All Inc Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Innovative Wound Care Associates Inc2 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, 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": "1373587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374019200000",
    "number": "1881035343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N KEEL RIDGE RD",
            "city": "HERMITAGE",
            "state": "PA",
            "postal_code": "161483440",
            "telephone_number": "800-471-8592",
            "fax_number": "866-742-6901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 BOARDMAN CANFIELD RD STE 3",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445124344",
            "telephone_number": "866-758-4862",
            "fax_number": "330-758-4886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE WOUND CARE ASSOCIATES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-12",
        "last_updated": "2013-07-17",
        "status": "A",
        "authorized_official_last_name": "BALKO",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "724-347-0591"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "PA",
            "license": "3951291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nature-All Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Boardman, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2013; 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.