NPIMap

Organization Active NPI

Portage Path Behavioral Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Akron, OH
National Provider Identifier
1881643633
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
PORTAGE PATH BEHAVIORAL HEALTH
Practice address
10 Penfield Ave
Akron, OH 44310-2912
Phone
(330) 762-6110
Fax
(330) 253-5248
NPI assigned
May 9, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Jerry T Kraker
Title
President
Phone
(330) 253-3100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU Primary

Addresses

Primary practice location

10 Penfield Ave
Akron, OH 44310-2912

Mailing address

340 S Broadway St
Akron, OH 44308-1529
Phone (330) 253-3100

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
36D1081674Portage Path Behavioral Health Psychiatric10 Penfield Avenue, Akron, OH 44310Certificate of waiverMar 23, 2028

National Provider Directory

National Provider Directory
Tax ID family
Portage Path Comm Menta4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

10 Penfield Ave
Akron, OH 44310
Phone (330) 253-3100

340 S Broadway St
Akron, OH 44308
Phone (330) 253-3100

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 153

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.

View all 153

NPI Registry JSON

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1881643633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 S BROADWAY ST",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443081529",
            "telephone_number": "330-253-3100",
            "fax_number": "330-253-5248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 PENFIELD AVE",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443102912",
            "telephone_number": "330-762-6110",
            "fax_number": "330-253-5248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTAGE PATH BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KRAKER",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "330-253-3100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Akron, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.