Active NPI
Abigail Grace Conover
- Registered Dietitian
- Canton, OH
National Provider Identifier
1902658206
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- LD.09909
- Practice address
- 1320 Mercy Dr NW
Canton, OH 44708-2614 - Phone
- (330) 489-1199
- NPI assigned
- Apr 2, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | LD.09909 | OH | Primary |
Addresses
Primary practice location
1320 Mercy Dr NW
Canton, OH 44708-2614
Mailing address
1085 Reimer Rd Apt 102
Wadsworth, OH 44281-7405
Phone (419) 481-6463
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
| License | State | Type | Specialty |
|---|---|---|---|
| LD.09909 | OH | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1712016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712016000000",
"number": "1902658206",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1085 REIMER RD APT 102",
"city": "WADSWORTH",
"state": "OH",
"postal_code": "442817405",
"telephone_number": "419-481-6463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1320 MERCY DR NW",
"city": "CANTON",
"state": "OH",
"postal_code": "447082614",
"telephone_number": "330-489-1199"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONOVER",
"first_name": "ABIGAIL",
"middle_name": "GRACE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-04-02",
"last_updated": "2024-04-02",
"certification_date": "2024-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OH",
"license": "LD.09909",
"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 Apr 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.