NPIMap

Organization Active NPI

4M Emergency Systems Tod LLC

  • Emergency Medicine Physician
  • Warren, OH
National Provider Identifier
1902859556
Registry record updated Feb 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
4M EMERGENCY SYSTEMS TOD LLC
Practice address
1296 Tod PL NW
Warren, OH 44485-2474
Phone
(844) 474-4019
NPI assigned
May 17, 2006
Last updated
Feb 24, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2023

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

Authorized official

Name
Melissa Reese
Title
Provider Enrollment Officer
Phone
(855) 687-0618

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X Primary

Addresses

Primary practice location

1296 Tod PL NW
Warren, OH 44485-2474

Mailing address

4535 Dressler Rd NW
Canton, OH 44718-2545
Phone (330) 994-4409

Other identifiers 1

IdentifierTypeStateIssuer
000000385524OtherOHANTHEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060124000548 OH Part B Supplier - Clinic/Group Practice 3173547593 Receives reassigned benefits from 78 practitioners
Practice locations: Warren, OH

National Provider Directory

National Provider Directory

Locations

1296 Tod Pl NW
Ste 200
Warren, OH 44485
Phone (330) 306-5040

Practitioners & affiliated clinicians

Practitioners 101

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 101

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677196800000",
    "number": "1902859556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4535 DRESSLER RD NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182545",
            "telephone_number": "330-994-4409",
            "fax_number": "330-492-8489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1296 TOD PL NW",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444852474",
            "telephone_number": "844-474-4019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "4M EMERGENCY SYSTEMS TOD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2023-02-24",
        "certification_date": "2023-02-24",
        "status": "A",
        "authorized_official_last_name": "REESE",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT OFFICER",
        "authorized_official_telephone_number": "855-687-0618"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000385524",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.