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STARK COUNTY PHYSICIANS LLC
NPI 1154695815
Internal Medicine in Canton, OH

Active since February 28, 2012CLIA 36D0720497 · Waiver
4143 FULTON DR NW, CANTON, OH 44718(330) 244-8888(330) 244-8850 Get Directions Write a Review

NPPES record last updated: July 24, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Stark County Physicians Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

STARK COUNTY PHYSICIANS LLC (NPI 1154695815) is a healthcare organization registered as an internal medicine in Canton, Ohio and active in the NPI registry since February 2012. The organization holds a CLIA Waiver certificate valid through August 25, 2027, maintains a secondary practice location in Millersburg, and lists Steve K. Nam, Physician Member, as its authorized official.

NPPES Registry Identity

NPI1154695815
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameSTARK COUNTY PHYSICIANS LLC
Location Address4143 FULTON DR NWCanton, OH 44718-2819
Mailing Address4143 Fulton Dr NwCanton, OH 44718-2819 · (330) 244-8888 · Fax (330) 244-8850
Phone(330) 244-8888
Fax(330) 244-8850
Organization SubpartNo
Authorized OfficialSteve K. NamPhysician Member · (330) 244-8888
Enumeration DateFebruary 28, 2012
Last NPPES UpdateJuly 24, 2025
NPPES CertifiedJuly 24, 2025
✔ NPI 1154695815 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in OH · 35044948
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
4143 FULTON DR NW, Canton, OH 44718
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Secondary Practice Location 1

Location 15354 Township Rd 336Millersburg, OH 44654-9375 · Phone (330) 244-8888 · Fax (330) 244-8850

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Stark County Physicians Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

5

Medicare enrollment records show 5 clinicians reassign Medicare billing to Stark County Physicians LLC, which bills Medicare for the services they deliver. Of these, 4 practice at this address and 5 within 10 miles. They are listed nearest first.

Clinicians, nearest first (5)

Mallory Puckett, CNP
Nurse Practitioner
NPI 1447753520
4143 FULTON DR NW
Canton, OH 44718
(330) 244-8888
✔ PECOS✔ Accepts MedicareSame address
Joseph Fisher, CNP
Nurse Practitioner
NPI 1225143423
4143 FULTON DR NW
Canton, OH 44718
(330) 244-8888
✔ PECOSSame address
Heather Johnson
Nurse Practitioner
NPI 1407396922
4143 FULTON DR NW
Canton, OH 44718
(330) 244-8888
✔ PECOSSame address
Steve Nam, M.D.
Internal Medicine
NPI 1174788061
4143 FULTON RD NW
Canton, OH 44718
(330) 244-8888
✔ PECOS✔ Accepts MedicareSame address
Laura Holliger, CNP
Nurse Practitioner
NPI 1437605409
1441 S MAIN ST
North Canton, OH 44720
(330) 244-8888
✔ PECOS2.2 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 36D0720497

Stark County Physicians, LLC · Canton, OH
Active · expires Aug 25, 2027
CLIA Number36D0720497
Laboratory TypePhysician Office
Certificate Effective DateAugust 26, 2025
Certificate Expiration DateAugust 25, 2027
Laboratory DirectorSteve K. Nam
Laboratory Phone(330) 244-8888
Laboratory LocationStark County Physicians, LLC4143 Fulton Drive NW, Canton, OH 44718
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Stark County Physicians LLC's NPI number?

The NPI number for Stark County Physicians LLC is 1154695815. It was assigned to this organization in the NPPES registry on February 28, 2012.

Where is Stark County Physicians LLC located?

Stark County Physicians LLC is located at 4143 Fulton Dr NW, Canton, OH 44718. The listed phone number is (330) 244-8888.

What is Stark County Physicians LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Stark County Physicians LLC enrolled in Medicare?

Yes. Stark County Physicians LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Stark County Physicians LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians in 2 Medicare specialties reassign their Medicare billing to Stark County Physicians LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (4) and Internal Medicine (1). Of these, 4 practice at this address and 5 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Stark County Physicians LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 36D0720497) is associated with this NPI, valid through August 25, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Stark County Physicians LLC accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource and 1 other insurer list Stark County Physicians LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Stark County Physicians LLC was last updated on July 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.