Individual provider Active NPI

Charles Fox, CNP

  • Acute Care Nurse Practitioner
  • Poland, OH
National Provider Identifier
1891595849
Registry record updated Sep 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
APRN.CNP.0040194 Issued in OH
Practice address
715 E Western Reserve Rd
Poland, OH 44514-3358
Phone
(330) 726-3204
NPI assigned
Mar 18, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X APRN.CNP.0040194 OH Primary

Addresses

Primary practice location

715 E Western Reserve Rd
Poland, OH 44514-3358

Mailing address

715 E Western Reserve Rd
Poland, OH 44514-3358
Phone (330) 726-3204

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250925004546 OH Practitioner - Nurse Practitioner 1759886153 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4600 McAuley PL
Blue Ash, OH 45242-4765

4600 McAuley PL
Suite 600
Blue Ash, OH 45242-4778

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN.CNP.0040194OHMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Youngstown Specialty Care LLC CurrentSince Sep 10, 2025 Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC CurrentSince Sep 10, 2025 Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC Current Accepting new patients

Locations

4600 McAuley Pl
Ste 600
Blue Ash, OH 45242
Phone (513) 752-8000

410 W 10th Ave
Columbus, OH 43210
Phone (614) 293-5905

627 Eastland Ave SE
Ste 301
Warren, OH 44484
Phone (330) 392-3099

1044 Belmont Ave
Youngstown, OH 44504
Phone (330) 480-2182

715 E Western Reserve Rd
Youngstown, OH 44514
Phone (330) 726-3204

Interoperability endpoints

  • Direct secure messaging: cfox37096@direct.bsmhealth.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1742256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757462400000",
    "number": "1891595849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 E WESTERN RESERVE RD",
            "city": "POLAND",
            "state": "OH",
            "postal_code": "445143358",
            "telephone_number": "330-726-3204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 E WESTERN RESERVE RD",
            "city": "POLAND",
            "state": "OH",
            "postal_code": "445143358",
            "telephone_number": "330-726-3204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOX",
        "first_name": "CHARLES",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-03-18",
        "last_updated": "2025-09-10",
        "certification_date": "2025-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OH",
            "license": "APRN.CNP.0040194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poland, OH

Sources for this page

Verify at the official NPI Registry.