Active NPI
Ronald Emil Severtis Sr., DO
- Internal Medicine Physician
- Canton, OH
National Provider Identifier
1881760536
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- OS 2942 L
- Practice address
- 733 Market Avenue South
Canton VA Outpatient Clinic
Canton, OH 44202 - Phone
- (330) 489-4600
- Fax
- (330) 489-4615
- NPI assigned
- Nov 27, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | OS 2942 L | PA | Primary |
Addresses
Primary practice location
733 Market Avenue South
Canton VA Outpatient Clinic
Canton, OH 44202
Mailing address
733 Market Avenue South
Canton VA Outpatient Clinic
Canton, OH 44202
Phone (330) 489-4600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OS 2942 L | PA | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1881760536",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "733 MARKET AVENUE SOUTH",
"address_2": "CANTON VA OUTPATIENT CLINIC",
"city": "CANTON",
"state": "OH",
"postal_code": "44202",
"telephone_number": "330-489-4600",
"fax_number": "330-489-4615"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "733 MARKET AVENUE SOUTH",
"address_2": "CANTON VA OUTPATIENT CLINIC",
"city": "CANTON",
"state": "OH",
"postal_code": "44202",
"telephone_number": "330-489-4600",
"fax_number": "330-489-4615"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEVERTIS",
"first_name": "RONALD",
"middle_name": "EMIL",
"name_prefix": "Dr.",
"name_suffix": "Sr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-27",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "PA",
"license": "OS 2942 L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.