Manju Gupta, MD

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

35044556 Issued in OH

Practice address

100 River Valley Blvd
New Richmond, OH 45157-8566

Phone

(513) 553-3114

Fax

(513) 553-1032

NPI assigned

Nov 14, 2005

Last updated

Sep 10, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599696000000",
    "number": "1093797318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 WARDS CORNER RD STE 200",
            "city": "LOVELAND",
            "state": "OH",
            "postal_code": "451406966",
            "telephone_number": "513-707-4041",
            "fax_number": "513-576-1020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 RIVER VALLEY BLVD",
            "city": "NEW RICHMOND",
            "state": "OH",
            "postal_code": "451578566",
            "telephone_number": "513-553-3114",
            "fax_number": "513-553-1032"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4627 Aicholtz Rd",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452441447",
            "country_code": "US",
            "telephone_number": "513-753-2820",
            "fax_number": "513-753-2824",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "MANJU",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-14",
        "last_updated": "2020-09-10",
        "certification_date": "2020-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "OH",
            "license": "35044556",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0418766",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christine Finitzer, MSW, LISW
• Elizabeth Frances Fowler
• Julie Clay Gislason, LISW-S
• Michelle Grandstaff
• Cynthia Groman
• Daniel Edmund Hadley
• Healthsource of Ohio, Inc. (HealthSource: New Richmond Family Practice)
• Healthsource of Ohio, Inc. (HealthSource: New Richmond Family Practice)
• Nancy M Hoffman, CNP
• Ronald Lee Hoover, PH.D

• Pediatric Adolescent Medicine Physician in New Richmond, OH
• Providers in New Richmond, OH by specialty
• Pediatric Adolescent Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.