Active NPI
Subbarao Cherukuri, M.D.
- Diagnostic Radiology Physician
- Newark, OH
National Provider Identifier
1003803537
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 35037688C
- Practice address
- 2112 Cherry Valley Rd
Newark, OH 43055-1323 - Phone
- (740) 522-3774
- Fax
- (740) 522-2221
- NPI assigned
- Sep 30, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 35037688C | OH | Primary |
Addresses
Primary practice location
2112 Cherry Valley Rd
Newark, OH 43055-1323
Mailing address
2112 Cherry Valley Rd
P O Box 948
Newark, OH 43055-1323
Phone (740) 522-3774
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0489047 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35037688C | OH | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Riverside Radiology and Interventional Associates Inc | Diagnostic Radiology | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Diagnostic Radiology Physician
- Columbus, OH
- NPI 1093718496
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128038400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1276646400000",
"number": "1003803537",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2112 CHERRY VALLEY RD",
"address_2": "P O BOX 948",
"city": "NEWARK",
"state": "OH",
"postal_code": "430551323",
"telephone_number": "740-522-3774",
"fax_number": "740-522-2221"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2112 CHERRY VALLEY RD",
"city": "NEWARK",
"state": "OH",
"postal_code": "430551323",
"telephone_number": "740-522-3774",
"fax_number": "740-522-2221"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHERUKURI",
"first_name": "SUBBARAO",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-30",
"last_updated": "2010-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "OH",
"license": "35037688C",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0489047",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Newark, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.