Gregory J. Bonavita
Internal Medicine (Clinical Cardiac Electrophysiology)

Address: 2600 6th St Sw, Suite A2-710, Canton, OH 44710-1702
Phone: 4404548076

Gregory J. Bonavita (NPI# 1306825336) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1306825336
Entity Type Individual
Full Name Gregory J. Bonavita
Credential M.D.
Gender Male
Practice Address 2600 6th St Sw
Suite A2-710
Canton
OH 44710-1702
Practice Telephone 4404548076
Practice Fax Number 3304543927
Mailing Address 2600 6th St Sw
Suite A2-710
Canton
OH 44710-1702
Mailing Telephone 4404548076
Mailing Fax Number 3304543927
Sole Proprietor No, this individual is not a Sole Proprietor
Enumeration Date 2006-01-10
Last Update Date 2008-04-17

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
Yes 207RC0001X Internal Medicine · Clinical Cardiac Electrophysiology Allopathic & Osteopathic Physicians 35-06-7797 OH

Other Provider Identifier

State Identifier Issuer Type Code
OH 0128883 MEDICAID

Physician Overview

NPI 1306825336
PAC ID by PECOS 4183511066
Professional Enrollment ID I20090203000257
Full Name Gregory J Bonavita
Organization Legal Name OHIO PHYSICIAN PROFESSIONAL CORPORATION
Phone Number 3303431335
Gender M
Medical School UMDNJ-NEW JERSEY MEDICAL SCHOOL
Graduation Year 1986
Primary Specialty CARDIAC ELECTROPHYSIOLOGY
Secondary Specialties INTERNAL MEDICINE
Group Practice PAC ID 2668406059
Number of Group Practice Members 138
Accepts Medicare Assignment Y
Report Quality Measures Y
Use Electronic Health Records Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
360084 AULTMAN HOSPITAL
360070 MERCY MEDICAL CENTER
360131 ALLIANCE COMMUNITY HOSPITAL

Office Location

Street Address 2600 6TH ST SW
SUITE A2-710
City CANTON
State OH
Zip Code 44710-1702

Providers in the same location

NPI Name Taxonomy Address Enumeration
1700885142 Michael W Soehnlen Radiology 2600 6th St Sw, Radiology Associates of Canton, Inc., Canton, OH 44710-1702 2005-07-19
1235608209 Elise Coudriet Nurse Practitioner 2600 6th St Sw, Canton, OH 44710-1799 2018-11-19
1114494341 Nicholas Gotschall Nurse Practitioner 2600 6th St Sw, Canton, OH 44710-1702 2018-10-25
1982189734 Leslie Gunion Nurse Anesthetist, Certified Registered 2600 6th St Sw, Canton, OH 44710-1702 2018-09-27
1356825053 Phillip Shearer Nurse Anesthetist, Certified Registered 2600 6th St Sw, Canton, OH 44710-1702 2018-09-18
1861971137 Brent Andrew Nowicki Physician Assistant 2600 6th St Sw, Canton, OH 44710-1702 2018-08-08
1720588320 Julie Renee Robinson Nurse Practitioner 2600 6th St Sw, Canton, OH 44710-1702 2018-02-20
1306350947 Jennifer Adele Lute Nurse Practitioner 2600 6th St Sw, Canton, OH 44710-1702 2017-11-17
1861902355 Kyle William Albaugh Nurse Anesthetist, Certified Registered 2600 6th St Sw, Canton, OH 44710-1702 2017-10-10
1316466998 Tabitha Joy Lockhart Physician Assistant 2600 6th St Sw, Canton, OH 44710-1702 2017-09-14
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1093219024 Philip Anthony Femano IIi Student in an Organized Health Care Education/Training Program Amanda Fouts; Medical Education, 2600 6th St Sw, Canton, Oh 44710, Canton, OH 44710 2018-03-23
1962949883 Chauntelle Andrews Nursing Care 3210 14th St Sw, Canton, OH 44710 2017-01-30
1770032146 Tammy Lamotte Registered Nurse 3302 11th St Sw, Canton, OH 44710 2016-09-27
1861898280 Heather Nicole Burrier Registered Nurse 2823 9th St. Sw, Cedar School, Canton, OH 44710 2014-11-12
1437569688 Kameika Thomas Licensed Practical Nurse 2704 9th St Sw, Canton, OH 44710 2014-04-28
1043444649 Laurie L Hanne Internal Medicine 2600 6th St.sw, Canton, OH 44710 2009-05-11
1164664124 George Papacostas, LLC General Acute Care Hospital 2600 6th Street Sw, Aultman Wound Care Center, Canton, OH 44710 2009-04-06
1598904419 Donna Fall Blackwell Nurse Practitioner 2600 6th Street, Canton, OH 44710 2009-02-17
1104921980 Brooks E Bolyard Pathology 2600 Sixth St, Canton, OH 44710 2006-09-14
1013012897 Daniel Wasdahl Pathology 2600 6th St, Canton, OH 44710 2006-09-14
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Taxonomy Information

Taxonomy Code 207RC0001X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Clinical Cardiac Electrophysiology

Taxonomy Definition

A field of special interest within the subspecialty of cardiovascular disease, specialty of Internal Medicine, which involves intricate technical procedures to evaluate heart rhythms and determine appropriate treatment for them.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1780623645 Firas M.a. Hamdan Internal Medicine 4466 Fulton Dr Nw, Canton, OH 44718-2864 2006-06-06
1427333293 Wellstar Cardiovascular Medicine, LLC Internal Medicine 720 Transit Ave, Suite 102, Canton, GA 30114-2540 2011-10-12
1265411243 Srinivasa Dinakar Satti Internal Medicine 2600 6th St Sw, Suite A2-710, Canton, OH 44710-1702 2006-01-10

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1275817793 The Dayton Heart Center, Inc. Internal Medicine 6623 Centerville Business Pkwy, Centerville, OH 45459-2655 2011-10-03
1720378243 Ismail Hamam Internal Medicine 473 West 12th Ave, Dhlri 200, Columbus, OH 43210 2011-04-18
1073769709 Dina Marie Sparano Internal Medicine 6801 Mayfield Rd Ste 300, Mayfield Heights, OH 44124 2008-08-13
1326202433 Ayman Ali Hussein Internal Medicine 9500 Euclid Ave # J2-2, Cardiac Electrophysiology, Cleveland, OH 44195-0001 2008-07-17
1518137017 Bryan Baranowski Internal Medicine Cleveland Clinic F15 Mailing Desk, 9500 Euclid Ave, Cleveland, OH 44195-0001 2008-03-11
1821287509 Shervin Sadrpour Internal Medicine 4760 E. Galbraith Road, Suite 205, Cincinnati, OH 45236-6704 2007-10-18
1366504599 Ottorino Costantini Internal Medicine 2500 N Metrohealth Drive, Cleveland, OH 44109 2006-12-14
1760471692 Ashraf Koraym Internal Medicine 2365 Lakeview Dr, Suite D, Beavercreek, OH 45431-4600 2005-10-13
1275531899 Indiresha Ramachandra Iyer Internal Medicine 32778 S Roundhead Dr, Solon, OH 44139-4851 2005-07-08
1174520464 Sheldon Louis Brownstein Internal Medicine 8251 Pine Rd, Ste 220, Cincinnati, OH 45236 2005-07-01
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City CANTON
Zip Code 44710

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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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