Individual

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

INDIVIDUAL

Practice address

1111 Gonder Av SE
Canton, OH 44707

Phone

(330) 265-7902

NPI assigned

Sep 1, 2016

Last updated

Sep 1, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Miss Tammie Lynn Mayle

Title

Home Health Aid

Phone

(330) 265-7902

Specialties & licenses 1

Addresses

Tax ID family

Individual2 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.

• Individual

  • Preferred Provider Organization
  • Canton, OH
  • NPI 1720537780
  NPD tax ID

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

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472688000000",
    "number": "1962958512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 GONDER AV SE",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "44707",
            "telephone_number": "330-265-7902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 GONDER AV SE",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "44707",
            "telephone_number": "330-265-7902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIVIDUAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-01",
        "last_updated": "2016-09-01",
        "status": "A",
        "authorized_official_last_name": "MAYLE",
        "authorized_official_first_name": "TAMMIE",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "HOME HEALTH AID",
        "authorized_official_telephone_number": "330-265-7902",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Philip H Iffland, D.D.S.
• James E Ijoma, CSP
• Cristina Dawn Ilijevski, APRN-CNP
• Imprinting LLC
• Individual
• Amy Indorf, MD
• Infusion Partners, LLC (BioScrip Infusion Services)
• Amita Ingale
• Deeana Renee Ingol
• Brandy Dunyelle Ingram

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Canton, OH
• Providers in Canton, OH by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.