Individual provider Active NPI

Brian J Fraley

  • Home Modifications Contractor
  • Canton, OH
National Provider Identifier
1891308169
Registry record updated Aug 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Modifications ContractorTaxonomy code 171WH0202X
License
10385 Issued in OH
Practice address
1326 37TH St NW
Canton, OH 44709-2640
Phone
(330) 265-8420
NPI assigned
Aug 26, 2020
Last updated
Aug 26, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Modifications Contractor 171WH0202X 10385 OH Primary

Addresses

Primary practice location

1326 37TH St NW
Canton, OH 44709-2640

Mailing address

1326 37TH St NW
Canton, OH 44709-2640
Phone (330) 265-8420

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
10385OHMDHome Modifications Contractor

NPI Registry JSON

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

{
    "created_epoch": "1598400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598400000000",
    "number": "1891308169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1326 37TH ST NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447092640",
            "telephone_number": "330-265-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1326 37TH ST NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447092640",
            "telephone_number": "330-265-8420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRALEY",
        "first_name": "BRIAN",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-08-26",
        "last_updated": "2020-08-26",
        "certification_date": "2020-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171WH0202X",
            "taxonomy_group": "",
            "desc": "Contractor, Home Modifications",
            "state": "OH",
            "license": "10385",
            "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 Aug 26, 2020; 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.