NPIMap

Organization Active NPI

Diabetes & Endocrinology Associates of Stark County Incorporated

  • Endocrinology, Diabetes & Metabolism Physician
  • Canton, OH
National Provider Identifier
1003841669
Registry record updated Feb 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
Legal business name
DIABETES & ENDOCRINOLOGY ASSOCIATES OF STARK COUNTY INCORPORATED
Practice address
4565 Dressler Rd NW
Suite #111
Canton, OH 44718-2579
Phone
(330) 493-0013
Fax
(330) 493-6973
NPI assigned
Jul 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Arvind Y Krishna, M.D.NPI 1275579542
Title
Owner
Phone
(330) 493-0013

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RE0101X Primary

Addresses

Primary practice location

4565 Dressler Rd NW
Suite #111
Canton, OH 44718-2579

Mailing address

4565 Dressler Rd NW
Suite #111
Canton, OH 44718-2579
Phone (330) 493-0013

Other identifiers 1

IdentifierTypeStateIssuer
0632622MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050922000038 OH Part B Supplier - Clinic/Group Practice 4880628569 Receives reassigned benefits from 9 practitioners
Practice locations: Canton, OH

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D0343607Diabetes & Endocrinology Associates4565 Dressler Rd NW, Canton, OH 44718Certificate of waiverOct 8, 2026

National Provider Directory

National Provider Directory

Locations

4565 Dressler Rd NW
Ste 111
Canton, OH 44718
Phone (216) 493-0013

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391558400000",
    "number": "1003841669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4565 DRESSLER RD NW",
            "address_2": "SUITE #111",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182579",
            "telephone_number": "330-493-0013",
            "fax_number": "330-493-6973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4565 DRESSLER RD NW",
            "address_2": "SUITE #111",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182579",
            "telephone_number": "330-493-0013",
            "fax_number": "330-493-6973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIABETES & ENDOCRINOLOGY ASSOCIATES OF STARK COUNTY INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-12",
        "last_updated": "2014-02-05",
        "status": "A",
        "authorized_official_last_name": "KRISHNA",
        "authorized_official_first_name": "ARVIND",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "330-493-0013",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0632622",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.