Mark S. Brigham, DO, Inc.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

34005567 Issued in OH

Legal business name

MARK S. BRIGHAM, DO, INC.

Practice address

195 Wadsworth Rd
Suite 401
Wadsworth, OH 44281-9504

Phone

(330) 336-8717

Fax

(330) 335-0092

NPI assigned

Nov 20, 2007

Organization subpart

No

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

Authorized official

Name

Darcilla Olshavsky

Title

Manager

Phone

(330) 336-8717

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Locations

Practitioners 3

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.

• Mark Steven Brigham, DO

  • Otolaryngology Physician
  • Wadsworth, OH
  • NPI 1740261387
  Medicare reassignment Care Compare group NPD
• Natalie Ann Topp, FNP-C

  • Family Nurse Practitioner
  • Wadsworth, OH
  • NPI 1639949217
  Medicare reassignment Care Compare group NPD
• Tiffany A Wagar, AU.D.

  • Audiologist
  • Wadsworth, OH
  • NPI 1619131950
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1195516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287014400000",
    "number": "1922289875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 WADSWORTH RD",
            "address_2": "SUITE 401",
            "city": "WADSWORTH",
            "state": "OH",
            "postal_code": "442819504",
            "telephone_number": "330-336-8717",
            "fax_number": "330-335-0092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 WADSWORTH RD",
            "address_2": "SUITE 401",
            "city": "WADSWORTH",
            "state": "OH",
            "postal_code": "442819504",
            "telephone_number": "330-336-8717",
            "fax_number": "330-335-0092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK S. BRIGHAM, DO, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-20",
        "last_updated": "2010-10-14",
        "status": "A",
        "authorized_official_last_name": "OLSHAVSKY",
        "authorized_official_first_name": "DARCILLA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "330-336-8717"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "OH",
            "license": "34005567",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2809250",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0180398",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diane Melynne Magas
• Magnolia Village Retirement Community, LTD (Magnolia Villiage Skilled Nursing and Rehabilitation)
• Neeraj Mahajan, MD
• Amy Mancini, IMFT
• Bruce L Manning, O.D.
• Kevin D Markowski, M.D.
• Richard Maroon, LPCC-S
• Matthew John Marr, D.C.
• Zachary Martin, D.C.
• Robin D Marty

• Otolaryngology Physician in Wadsworth, OH
• Providers in Wadsworth, OH by specialty
• Otolaryngology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2010; 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.