CRYSTAL CLINIC ORTHOPAEDIC CENTER, LLC (NPI# 1366002321) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1366002321 |
Entity Type | Organization |
Organization Name | CRYSTAL CLINIC ORTHOPAEDIC CENTER, LLC |
Practice Address |
4466 Fulton Dr Nw Canton OH 44718-2864 |
Mailing Address |
Po Box 72434 Cleveland OH 44192-0002 |
Practice Telephone | 3306684065 |
Practice Fax Number | 3306684082 |
Mailing Telephone | 3306684040 |
Mailing Fax Number | 3306640694 |
Enumeration Date | 2019-06-20 |
Last Update Date | 2019-06-20 |
Authorized Official Name | RONALD R SUNTKEN (PRESIDENT/CEO) |
Authorized Official Telephone | 3306704152 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 284300000X | Special Hospital | Hospitals |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1558922476 | Crystal Clinic Orthopaedic Center, LLC | Special Hospital | 1 Eagle Valley Ct Ste 101, Broadview Hts, OH 44147-2982 | 2019-06-21 |
1134602808 | Crystal Clinic Orthopaedic Center, LLC | Special Hospital | 500 W Hopocan Ave Ste 102, Barberton, OH 44203-2262 | 2018-09-10 |
1013428259 | Crystal Clinic Orthopaedic Center, LLC | Special Hospital | 437 Portage Trl Ste B, Cuyahoga Falls, OH 44221-3227 | 2017-10-16 |
1467979971 | Crystal Clinic Orthopaedic Center, LLC | Pharmacy | 444 N Main St Fl 1, Akron, OH 44310-3110 | 2017-08-25 |
1881138063 | Crystal Clinic Orthopaedic Center, LLC | Special Hospital | 3975 Embassy Pkwy, Suite 003, Akron, OH 44333-8320 | 2016-12-07 |
1801338033 | Crystal Clinic Orthopaedic Center, LLC | Special Hospital | 4975 Foote Rd, Suite 200, Medina, OH 44256-8748 | 2016-11-04 |
1578005708 | Crystal Clinic Orthopaedic Center, LLC | Special Hospital | 1622 E Turkeyfoot Lake Rd, 201, Akron, OH 44312-5277 | 2016-11-04 |
1447528930 | Crystal Clinic Orthopaedic Center, LLC | Special Hospital | 3925 Embassy Pkwy, Suite 300, Akron, OH 44333-1782 | 2011-12-12 |
1225313448 | Crystal Clinic Orthopaedic Center, LLC | Special Hospital | 323 High St, Suite C, Wadsworth, OH 44281-1869 | 2011-10-19 |
1639402266 | Crystal Clinic Orthopaedic Center, LLC | Special Hospital | 9318 State Route 14, Streetsboro, OH 44241-5224 | 2009-09-15 |
Entity Type | Entity Name | Entity Address |
---|---|---|
System for Award Management (SAM) Entities | CRYSTAL CLINIC ORTHOPAEDIC CENTER, LLC | 3925 Embassy Pkwy Ste 250, Akron, OH 44333-1799 |
Street Address |
4466 FULTON DR NW |
City | CANTON |
State | OH |
Zip Code | 44718-2864 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1780623645 | Firas M.a. Hamdan | Internal Medicine | 4466 Fulton Dr Nw, Canton, OH 44718-2864 | 2006-06-06 |
1609427004 | Mary Peterson | Physician Assistant | 4466 Fulton Dr Nw, Canton, OH 44718-2864 | 2019-09-26 |
1568873446 | Jordan Etscheidt | Orthopaedic Surgery | 4466 Fulton Dr Nw, Canton, OH 44718-2864 | 2014-05-14 |
1831441831 | Stacey Lynn Keller | Physician Assistant | 4466 Fulton Dr Nw, Canton, OH 44718-2864 | 2012-10-15 |
1962792515 | Shayda Mirhaidari | Plastic Surgery | 4466 Fulton Dr Nw, Canton, OH 44718-2864 | 2011-04-17 |
1922288778 | Rebecca L. Wolfe | Physician Assistant | 4466 Fulton Dr Nw, Canton, OH 44718-2864 | 2007-11-09 |
1114026226 | Cardiology One, Inc | Internal Medicine | 4466 Fulton Dr Nw, Canton, OH 44718-2864 | 2006-09-22 |
1578585956 | Tiffany M. Fisher | Physician Assistant | 4466 Fulton Dr Nw, Canton, OH 44718-2864 | 2006-07-24 |
1003850710 | Todd L Johnson | Internal Medicine | 4466 Fulton Dr Nw, Canton, OH 44718-2864 | 2006-06-15 |
1851334973 | Brian E Simmons | Internal Medicine | 4466 Fulton Dr Nw, Canton, OH 44718-2864 | 2006-06-14 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1639658057 | Christine Lynn Mccrone | Psychologist | 4450 Belden Village St Nw Ste 701, Canton, OH 44718 | 2018-08-07 |
1295252500 | Dora C Holliday | Student in an Organized Health Care Education/Training Program | 4641 Fulton Dr N.w., Canton, OH 44718 | 2017-08-28 |
1770035487 | A B A Let's Play, Inc. | Community/Behavioral Health | 6304 Shipslanding Ave Nw, Canton, OH 44718 | 2016-10-28 |
1457710139 | Aria Lg Counseling and Wellness Center, LLC | Clinic/Center | 5262 Fulton Road Nw, Canton, OH 44718 | 2016-02-23 |
1457722365 | Melinda R Bond | Nurse Practitioner | 4105 Holiday Street Nw, Canton, OH 44718 | 2015-10-19 |
1164804860 | Ashley Marie Whetsell | Dentist | 4550 Belden Village Street Nw, Canton, OH 44718 | 2015-06-18 |
1346643749 | Emil D. Poporad, Dds | Dentist | 4124 Fulton Rd. N.w., Suite 102, Canton, OH 44718 | 2014-09-30 |
1699198390 | Lauri Sanders | Social Worker | 5860 Fulton Dr Nw, Canton, OH 44718 | 2014-01-31 |
1376893768 | Courteney R Briceland | Social Worker | 4641 Fulton Rd. Nw, Canton, OH 44718 | 2012-09-13 |
1982953220 | Lyudmyla Z Rockaway | Marriage & Family Therapist | 4895 Dressler Road Nw, Ste A, Canton, OH 44718 | 2012-08-31 |
Find all providers in zip 44718 |
Taxonomy Code | 284300000X |
Grouping | Hospitals |
Classification | Special Hospital |
A designation by the AHA of a hospital whose primary function of the institution is to provide diagnostic and treatment services for patients who have specified medical conditions, both surgical and nonsurgical. |
Notes: Source: AHA Guide, Registration section, p. A5. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619588787 | Promedica Physicians At Home, LLC | Special Hospital | 1801 Richards Rd, Toledo, OH 43607-1037 | 2020-08-12 |
1558922476 | Crystal Clinic Orthopaedic Center, LLC | Special Hospital | 1 Eagle Valley Ct Ste 101, Broadview Hts, OH 44147-2982 | 2019-06-21 |
1134602808 | Crystal Clinic Orthopaedic Center, LLC | Special Hospital | 500 W Hopocan Ave Ste 102, Barberton, OH 44203-2262 | 2018-09-10 |
1225528938 | Wellcare Health System, LLC | Special Hospital | 241 N Superior St Ste 102, Toledo, OH 43604-1253 | 2018-05-17 |
1013428259 | Crystal Clinic Orthopaedic Center, LLC | Special Hospital | 437 Portage Trl Ste B, Cuyahoga Falls, OH 44221-3227 | 2017-10-16 |
1952832305 | Long Island Jewish Forest Hills Hospital | Special Hospital | 3590 Blackberry Ln, Westlake, OH 44145-7400 | 2017-03-27 |
1770025652 | Aultman Radiation Oncology of Alliance Community Hosp | Special Hospital | 885 South Sawburg Ave Suite 108, Alliance, OH 44601-5926 | 2016-11-09 |
1245685452 | Rock Creek Medical Center | Special Hospital | 2863 St Rt 45 N, Rock Creek, OH 44084 | 2016-04-26 |
1558785329 | Saskia Richter | Special Hospital | 1442 Neil Ave Apt A, Columbus, OH 43201-2651 | 2014-02-13 |
1750626735 | Acuity Specialty Hospital | Special Hospital | 4697 Harrison St Fl 2, Bellaire, OH 43906-1338 | 2012-12-03 |
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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.