NPIMap

Organization Active NPI

Stark Recovery Associates, LLC

  • Community/Behavioral Health Agency
  • Canton, OH
National Provider Identifier
1912641481
Registry record updated Feb 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
STARK RECOVERY ASSOCIATES, LLC
Practice address
3801 Whipple Ave NW Ste 1
Canton, OH 44718-4802
Phone
(216) 413-0413
Fax
(888) 509-7989
NPI assigned
Apr 21, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2023

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

Authorized official

Name
Carla Hart-Tyner, NP-CNPI 1134476088
Title
Nurse Practitioner/Owner
Phone
(216) 413-0413

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X

Addresses

Primary practice location

3801 Whipple Ave NW Ste 1
Canton, OH 44718-4802

Mailing address

3801 Whipple Ave NW Ste 1
Canton, OH 44718-4802
Phone (216) 413-0413

Electronic endpoints 2

TypeEndpointUseAffiliation
Other URL mail@starkrecoveryassociates.com
Other URL mail@starkrecoveryassociates.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230511000604 OH Part B Supplier - Clinic/Group Practice 6002272309 Receives reassigned benefits from 4 practitioners
Practice locations: Canton, OH

National Provider Directory

National Provider Directory
Tax ID family
Stark Recovery Associates2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1650499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676851200000",
    "number": "1912641481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 WHIPPLE AVE NW STE 1",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447184802",
            "telephone_number": "216-413-0413",
            "fax_number": "888-509-7989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 WHIPPLE AVE NW STE 1",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447184802",
            "telephone_number": "216-413-0413",
            "fax_number": "888-509-7989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STARK RECOVERY ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-21",
        "last_updated": "2023-02-20",
        "certification_date": "2023-02-20",
        "status": "A",
        "authorized_official_last_name": "HART-TYNER",
        "authorized_official_first_name": "CARLA",
        "authorized_official_title_or_position": "NURSE PRACTITIONER/OWNER",
        "authorized_official_telephone_number": "216-413-0413",
        "authorized_official_credential": "NP-C"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "mail@starkrecoveryassociates.com",
            "affiliation": "N",
            "address_1": "3801 Whipple Ave NW Ste 1",
            "city": "Canton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "447184802",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "mail@starkrecoveryassociates.com",
            "affiliation": "N",
            "address_1": "3801 Whipple Ave NW Ste 1",
            "city": "Canton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "447184802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Feb 20, 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.