Active NPI
Earl Wayne Pander, PTA
- Physical Medicine & Rehabilitation Physician
- Canton, OH
National Provider Identifier
1932975273
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- License
- 06331
- Practice address
- 4653 Roosevelt Ave NE
Canton, OH 44705-2952 - Phone
- (330) 327-9016
- NPI assigned
- Nov 28, 2023
- Last updated
- Nov 28, 2023
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | 06331 | OH | Primary |
Addresses
Primary practice location
4653 Roosevelt Ave NE
Canton, OH 44705-2952
Mailing address
East Liverpool City Hospital
425
East Liverpool, OH 43920
Phone (330) 385-7200
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 |
|---|---|---|---|
| 06331 | OH | MD | Physical Medicine & Rehabilitation Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1701129600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701129600000",
"number": "1932975273",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "EAST LIVERPOOL CITY HOSPITAL",
"address_2": "425",
"city": "EAST LIVERPOOL",
"state": "OH",
"postal_code": "43920",
"telephone_number": "330-385-7200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4653 ROOSEVELT AVE NE",
"city": "CANTON",
"state": "OH",
"postal_code": "447052952",
"telephone_number": "330-327-9016"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PANDER",
"first_name": "EARL",
"middle_name": "WAYNE",
"name_prefix": "Mr.",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-11-28",
"last_updated": "2023-11-28",
"certification_date": "2023-11-24",
"status": "A"
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "OH",
"license": "06331",
"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 Nov 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.