1447286935 NPI number — MRS. SUZANNE OLIVIA BIGGS D.O.

Table of content: KILEY FELTON CRNP (NPI 1831577204)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447286935 NPI number — MRS. SUZANNE OLIVIA BIGGS D.O.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BIGGS
Provider First Name:
SUZANNE
Provider Middle Name:
OLIVIA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
D.O.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447286935
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/09/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7689 PINE RIDGE ST NW
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTH CANTON
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44720-6397
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
330-830-4132
Provider Business Mailing Address Fax Number:
330-830-1129

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3821 WALES AVE NW
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
MASSILLON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44646-1821
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
330-830-4132
Provider Business Practice Location Address Fax Number:
330-830-1129
Provider Enumeration Date:
06/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  34007052B , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000000328558 . This is a "UNICARE PROVIDER #" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 733257 . This is a "BUCKEYE HEALTH PLAN" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 2159579 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000328558 . This is a "BCBS PROVIDER #" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 200830551027 . This is a "CARESOURCE PROVIDER #" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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