INDIVIDUAL (NPI# 1720537780) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720537780 |
| Entity Type | Organization |
| Organization Name | INDIVIDUAL |
| Practice Address |
1111 Gonder Avenue Se Canton OH 44707 |
| Mailing Address |
1111 Gonder Ave Se Canton OH 44707-3321 |
| Practice Telephone | 3302090732 |
| Mailing Telephone | 3302090732 |
| Enumeration Date | 2016-09-30 |
| Last Update Date | 2016-09-30 |
| Authorized Official Name | MISS TAMMIE LYNN MAYLE (HOME HEALTH AID) |
| Authorized Official Telephone | 3302090732 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 305R00000X | Preferred Provider Organization | OH | Managed Care Organizations |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962958512 | Individual | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1111 Gonder Av Se, Canton, OH 44707 | 2016-09-01 |
| 1356793509 | Individual | Clinic/Center | 3500 Timberwood Cir Apt 2137, Arlington, TX 76015-3129 | 2016-07-11 |
| 1669862587 | Individual | Specialist/Technologist | 2926 Waldon Park Dr, Orion, MI 48359-1336 | 2015-01-30 |
| 1780092817 | Individual | Skilled Nursing Facility | 5311 Albany Cir, Tobaccoville, NC 27050-9723 | 2014-08-01 |
| 1316361496 | Individual | Community/Behavioral Health | 2484 Ga Highway 100, Hogansville, GA 30230-3719 | 2014-02-11 |
| 1134534563 | Individual | Public Health or Welfare | 81 Plantation Street, Worcester, MA 01604 | 2014-06-24 |
| 1881019123 | Individual | Community/Behavioral Health | 12966 Euclid St, Suite 280, Garden Grove, CA 92840-5200 | 2014-02-24 |
| 1952724932 | Individual | Nursing Care | 1019 Westside Dr, Cuba, MO 65453-1025 | 2014-01-28 |
| 1639415920 | Individual | Residential Treatment Facility, Emotionally Disturbed Children | 1725 Shivers Rd, Columbia, SC 29210-5413 | 2012-12-14 |
| 1558663963 | Individual | Clinic/Center | 8105 Hidden Quail Ave, Las Vegas, NV 89131-4647 | 2010-11-17 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | INDIVIDUAL | 200 E Pine St, Somonauk, IL 60552-9812 |
| Virginia Business Entities | Individual & Employee Wellness LLC | 244 Ridgeway Drive, Farmville, Virginia 23901 |
| Oregon Corporations, Companies and Business Names | INDIVIDUAL & FAMILY GROWTH CENTER-MICHOL POLSON PHD | 204 Riverside Dr, Klamath Falls, OR 97601 |
| Colorado Business Entities | Individual & Family Recovery Inc. | 420 21st Ave., Suite 115, Longmont, CO 80501 |
| Oklahoma Business Registrations | INDIVIDUAL & FAMILY SERVICE L.L.C. | 2840 E 52nd St Ste 105, Tulsa, OK 74105 |
| Massachusetts Corporations | INDIVIDUAL & FAMILY SUPPORT CENTERS, INC. | 81 Hope Avenue, Worcester, MA 02721 |
| Virginia Business Entities | INDIVIDUAL & GROUP HEALTH PLANS INC. | 6025 Lee Hwy Ste 415, Chattanooga, Tennessee 37421 |
| Colorado Business Entities | Individual 1 | 17900 E 56th Ave, Apt 113, Denver, CO 80249 |
| Colorado Business Entities | Individual Academic Development, LLC | Po Box 2109, Parker, CO 80134 |
| Colorado Business Entities | Individual Advantages Inc | 617 Church Road, Elgin, IL 60123 |
| Street Address |
1111 GONDER AVENUE SE |
| City | CANTON |
| State | OH |
| Zip Code | 44707 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649781717 | Linda Wilt | Licensed Practical Nurse | 620market Ave. S., Canton, OH 44707 | 2017-10-17 |
| 1558872622 | Michele Rose Strongoli-scott | Registered Nurse | 1620 Market Ave S., Canton, OH 44707 | 2017-10-17 |
| 1366972234 | Terri Sue Clendenin | Home Health Aide | 1317 Mattie St Sw, Canton, OH 44707 | 2017-06-14 |
| 1215467311 | Draya K Ellis | Community Health Worker | 408 9th Street Sw, Canton, OH 44707 | 2017-06-13 |
| 1962958512 | Individual | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1111 Gonder Av Se, Canton, OH 44707 | 2016-09-01 |
| 1184070526 | Mj Harvey Development, LLC | Day Training, Developmentally Disabled Services | 804 Marion Ave Sw, Canton, OH 44707 | 2016-05-04 |
| 1164898516 | Erica Marie Brown | Occupational Therapy Assistant | 1620 Market Ave., South, Canton, OH 44707 | 2015-08-19 |
| 1508256439 | Kenny Mcclelland | Military/U.S. Coast Guard Transport | 903 Alan Page Dr Se # Apt1, Canton, OH 44707 | 2015-01-30 |
| 1295143550 | Susan Elaine Ball | Technician | 908 6th St Sw, Canton, OH 44707 | 2014-07-30 |
| 1528488764 | Shala Lenee Brown | Registered Nurse | 401 14th St Se, Canton, OH 44707 | 2014-04-25 |
| Find all providers in zip 44707 | ||||
| Taxonomy Code | 305R00000X |
| Grouping | Managed Care Organizations |
| Classification | Preferred Provider Organization |
| A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. |
| Notes: Source: "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/ October 1995, p. 62 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023353885 | Prabhu, LLC | Preferred Provider Organization | 43680 Laurelwood Dr, Canton, MI 48187-4916 | 2012-12-05 |
| 1730635400 | Muse Counseling, LLC | Preferred Provider Organization | 113 Mountain Brook Dr, Suite 108, Canton, GA 30115-9057 | 2016-08-31 |
| 1245691203 | Mind and Body Behavioral Health Center | Preferred Provider Organization | 575 Washington St, Unit 2d, Canton, MA 02021-3011 | 2016-03-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942815394 | Kris B Ingram | Preferred Provider Organization | 52 S Beaver St, Carroll, OH 43112-9002 | 2020-09-12 |
| 1235757907 | Ohio Elevator & Lift | Preferred Provider Organization | 9345 Ravenna Rd Unit F, Twinsburg, OH 44087-2452 | 2020-07-09 |
| 1013532746 | Austin Bishop | Preferred Provider Organization | 4271 Glenway Ave, Deer Park, OH 45236-3631 | 2020-06-09 |
| 1891317079 | D Lipold Enterprises LLC | Preferred Provider Organization | 1516 Crossings Pkwy, Westlake, OH 44145-6258 | 2020-05-11 |
| 1780109348 | Nathaniel M. Taylor, Dmd, LLC. | Preferred Provider Organization | 6391 Royalton Rd Ste A, North Royalton, OH 44133-4922 | 2017-08-04 |
| 1982130084 | Sharon Peterson | Preferred Provider Organization | 6118 Mayflower Ave, Cincinnati, OH 45237-4820 | 2017-05-10 |
| 1396285714 | Lisa Hissong | Preferred Provider Organization | 949 Guckert Ave, Newark, OH 43055-2635 | 2017-03-04 |
| 1811439680 | Shannon Vanestine Banks | Preferred Provider Organization | 1908 1st St, Sandusky, OH 44870-3904 | 2016-11-10 |
| 1891244810 | Christopher Bennett Mcgurk | Preferred Provider Organization | 464 Zahn Dr Apt 3, Akron, OH 44313-5556 | 2016-10-03 |
| 1942659537 | Nehdra Mccollum | Preferred Provider Organization | 5008 E 86th St, Garfield Hts, OH 44125-2000 | 2016-06-06 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.