JAMES EDWIN PROMMERSBERGER DPM NPI 1073584686

NPI Information

NPI: 1073584686
Provider Name: JAMES EDWIN PROMMERSBERGER, DPM
Classification: Podiatrist - 213E00000X
Entity Type: Individual
Address:
940 WINDHAM CT
SUITE #3
BOARDMAN, OH
ZIP 44512
Phone: (330) 726-3348
Get Directions

James Edwin Prommersberger, DPM is a podiatrist in Boardman, OH. The provider is a podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. James Edwin Prommersberger, DPM NPI is 1073584686. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

940 WINDHAM CT
SUITE #3
BOARDMAN, OH
ZIP 44512-060
Phone: (330) 726-3348
Fax: (330) 726-3856

The enumeration date for this NPI number is 1/31/2006 and was last updated on 6/2/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	213ES0103X	Podiatrist	Foot & Ankle Surgery	36-00-2619	OHIO	No
2	213E00000X	Podiatrist		36-00-2619	OHIO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	P00199462	OTHER	OHIO	MEDICARE TRAVELERS
2	T90004	MEDICARE UPIN	OHIO
3	0655751	MEDICARE PIN	WEST VIRGINIA
4	000000177949	OTHER	OHIO	ANTHEM
5	PR0655752	MEDICARE ID-TYPE UNSPECIFIED	OHIO
6	0774194	MEDICAID	OHIO
7	000601363	OTHER	WEST VIRGINIA	BLUE SHIELD MOUNTAIN STATE
8	0099572000	OTHER	WEST VIRGINIA	MEDICAID WV

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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