TAMMY LYNN MICCO


Address: 4650 Hills and Dales Rd Nw, Canton, OH 44708
Phone: 3306499400

TAMMY LYNN MICCO (NPI# 1265835102) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1265835102
Entity Type Individual
Full Name TAMMY LYNN MICCO
Credential N.P.
Practice Address 4650 Hills and Dales Rd Nw
Canton
OH 44708
Practice Telephone 3306499400
Practice Fax Number 3306498059
Mailing Telephone 3306499400
Mailing Fax Number 3306498059
Enumeration Date 2014-10-07
Last Update Date 2019-10-14
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363L00000X Nurse Practitioner NP16567 OH Physician Assistants & Advanced Practice Nursing Providers
N 363L00000X Nurse Practitioner 16567 OH Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
OH LICENSE NUMBER 16567 01

Office Location

Street Address 4650 HILLS AND DALES RD NW
City CANTON
State OH
Zip Code 44708

Providers in the same location

NPI Name Taxonomy Address Enumeration
1821094210 John R Garton Internal Medicine 4650 Hills and Dales Rd Nw, Canton, OH 44708 2005-06-22
1174176176 Eric Williams Physical Therapy Assistant 4650 Hills and Dales Rd Nw, Canton, OH 44708-6220 2019-07-18
1366914939 Kinga Karacson Physician Assistant 4650 Hills and Dales Rd Nw, Canton, OH 44708-6220 2018-12-20
1245771211 Malcolm Ford Specialist/Technologist 4650 Hills and Dales Rd Nw, Canton, OH 44708-6220 2017-03-10
1407392327 Amy Wellin Physician Assistant 4650 Hills and Dales Rd Nw, Canton, OH 44708-6220 2017-01-17
1235544198 Bhavnish Bucktowarsing Internal Medicine 4650 Hills and Dales Rd Nw, Canton, OH 44708 2014-06-30
1811230956 Olivia Myers Physician Assistant 4650 Hills and Dales Rd Nw, Canton, OH 44708-6220 2013-03-27
1568702702 Genevieve M Baumgardner Physical Therapist 4650 Hills and Dales Rd Nw, Suite 100, Canton, OH 44708-6220 2013-02-26
1760788368 Dayanand Makey Internal Medicine 4650 Hills and Dales Rd Nw, Canton, OH 44708 2011-01-31
1104133321 Laura R. Pierce Nurse Practitioner 4650 Hills and Dales Rd Nw, Canton, OH 44708-6220 2010-09-09
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1669072583 Xl Developmental Services, Inc. Home Health 4403 19th St Nw, Canton, OH 44708 2020-10-29
1942827084 Emily Glor Dentist 1320 Mercy Drive Northwest, Attn: Dental Services, Canton, OH 44708 2020-07-05
1811479009 Linda Adams Counselor 2421 13th Street Nw, Canton, OH 44708 2018-09-04
1104308527 Toreka Lishay Miller Social Worker 2421 13th Nw, Canton, OH 44708 2018-09-01
1679051213 Edward Arthur Hill Family Medicine 6104 Cedar Lane Nw, Canton, OH 44708 2018-08-06
1467939371 Kristen M Reardon Registered Nurse 1330 Mercy Dr Nw Ste 319, Canton, OH 44708 2018-07-24
1538659131 Jeffrey Scott Mechtenberg Chiropractor 3410 Tuscarawas Street W, Canton, OH 44708 2018-05-18
1699284844 Our Caring Hands Home Care, LLC Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 3005 W. Tuscuswas St, Canton, OH 44708 2017-09-20
1528580933 Elizabeth Ann Bonchek Licensed Practical Nurse 4550 Hills and Dales Nw Road, Canton, OH 44708 2017-07-07
1518315837 Bio-medical Applications of Ohio, Inc. Clinic/Center 2835 Tuscarawas St. West, Canton, OH 44708 2016-05-26
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Taxonomy Information

Taxonomy Code 363L00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner

Taxonomy Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1033754163 Kelly Marie Shirley Nurse Practitioner 450 Northside Cherokee Blvd., Radiology Dept., Canton, GA 30115 2019-11-13
1891286928 Joseph Vincent Bautista Doromal Nurse Practitioner 111 Mountain Brook Dr, Canton, GA 30115-9045 2018-05-24
1245748060 Renita Roychelle Strickland Nurse Practitioner 498 Chattin Dr, Canton, GA 30115-8240 2018-01-15
1487176921 Nguyet Tran Tyler Nurse Practitioner 1558 Riverstone Pkwy, Canton, GA 30114-2898 2017-07-15
1255865820 Mercedita Ungab-canete Nurse Practitioner 4019 Sarah Ann Dr, Canton, MI 48188-2193 2017-04-20
1720447477 Shafiq U Rehman Nurse Practitioner 41667 Quail Ct, Canton, MI 48188-5228 2016-02-22
1396119145 Marie Posy Nurse Practitioner 506 Blue Mountain Rise, Canton, GA 30114-5713 2015-11-17
1407231202 Advanced Wound and Ostomy Solutions Nurse Practitioner 203 River Green Ave, Canton, GA 30114-5846 2015-07-22
1427474527 Stephen Collins Nurse Practitioner 1684 Fallen Timber St Ne, Canton, OH 44721-3858 2014-03-13
1992030712 Cheryl Lynn Belopotosky Nurse Practitioner 733 Market Ave. Sw, Canton, OH 44702-1018 2009-10-13
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Competitor

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City CANTON
Zip Code 44708

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Dataset Information

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.

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