Organization Active NPI

Francis J. Waickman, M.D. & Associates, Inc.

  • Specialist
  • Fairlawn, OH
National Provider Identifier
1932381886
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
35-05-9856-W Issued in OH
Legal business name
FRANCIS J. WAICKMAN, M.D. & ASSOCIATES, INC.
Practice address
3090 W Market St Ste 110
Fairlawn, OH 44333-3615
Phone
(330) 867-3767
Fax
(330) 867-4857
NPI assigned
Dec 3, 2007
Last updated
Dec 4, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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

Authorized official

Name
Dr. Michael John Waickman, M.D.NPI 1386644631
Title
Practice Owner
Phone
(330) 867-3767

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 35-05-9856-W OH Primary

Addresses

Primary practice location

3090 W Market St Ste 110
Fairlawn, OH 44333-3615

Mailing address

3090 W Market St Ste 110
Fairlawn, OH 44333-3615
Phone (330) 867-3767

Other identifiers 1

IdentifierTypeStateIssuer
2197475MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100805000062 OH Part B Supplier - Clinic/Group Practice 1951434380 Receives reassigned benefits from 1 practitioner
Practice locations: Fairlawn, OH

National Provider Directory

National Provider Directory

Locations

544 White Pond Dr
Ste B
Akron, OH 44320
Phone (330) 867-3767

3090 W Market St
Fairlawn, OH 44333
Phone (330) 873-4850

3090 W Market St
Ste 110
Fairlawn, OH 44333
Phone (330) 836-7110

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1196640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733270400000",
    "number": "1932381886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3090 W MARKET ST STE 110",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443333615",
            "telephone_number": "330-867-3767",
            "fax_number": "330-867-4857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3090 W MARKET ST STE 110",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443333615",
            "telephone_number": "330-867-3767",
            "fax_number": "330-867-4857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRANCIS J. WAICKMAN, M.D. & ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-03",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A",
        "authorized_official_last_name": "WAICKMAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRACTICE OWNER",
        "authorized_official_telephone_number": "330-867-3767",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OH",
            "license": "35-05-9856-W",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2197475",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairlawn, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2024; 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.