Individual provider Active NPI

Christopher Bennett McGurk

  • Preferred Provider Organization
  • Akron, OH
National Provider Identifier
1891244810
Registry record updated Oct 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preferred Provider OrganizationTaxonomy code 305R00000X
License
0168567 Issued in OH
Practice address
464 Zahn Dr Apt 3
Akron, OH 44313-5556
Phone
(330) 329-5815
NPI assigned
Oct 3, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Preferred Provider Organization 305R00000X 0168567 OH Primary

Addresses

Primary practice location

464 Zahn Dr Apt 3
Akron, OH 44313-5556

Mailing address

254 Homewood Ave
Akron, OH 44312-1217
Phone (330) 907-4315

Other identifiers 1

IdentifierTypeStateIssuer
910000561905MedicaidOH

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

State licenses

LicenseStateTypeSpecialty
0168567OHMDPreferred Provider Organization

NPI Registry JSON

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

{
    "created_epoch": "1475452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475452800000",
    "number": "1891244810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "254 HOMEWOOD AVE",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443121217",
            "telephone_number": "330-907-4315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "464 ZAHN DR APT 3",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443135556",
            "telephone_number": "330-329-5815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGURK",
        "first_name": "CHRISTOPHER",
        "middle_name": "BENNETT",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-10-03",
        "last_updated": "2016-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "OH",
            "license": "0168567",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "910000561905",
            "state": "OH"
        }
    ],
    "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 Oct 3, 2016; 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.