Agatha A Chukwumerije, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

35067956 Issued in OH

Practice address

1930 Fulton Rd NW
Suite 101
Canton, OH 44709-3526

Phone

(330) 454-9766

Fax

(330) 454-3438

NPI assigned

Aug 21, 2006

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

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Other, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Medical Center Hospital, Canton, OH, CCN 360070
• Aultman Hospital Hospital, Canton, OH, CCN 360084

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: agatha.chukwumerije.1@16545.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Internal Medicine Specialists of Canton Inc

  • Internal Medicine Physician
  • Canton, OH
  • NPI 1801936786
  Medicare reassignment NPD Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Aultman Hospital

  • General Acute Care Hospital
  • Canton, OH
  • NPI 1356366991
  Care Compare affiliation
• Cleveland Clinic Mercy Hospital

  • General Acute Care Hospital
  • Canton, OH
  • NPI 1366433195
  Care Compare affiliation

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193961600000",
    "number": "1093820508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80690",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "44708",
            "telephone_number": "330-833-5530",
            "fax_number": "330-833-6085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 FULTON RD NW",
            "address_2": "SUITE 101",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447093526",
            "telephone_number": "330-454-9766",
            "fax_number": "330-454-3438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUKWUMERIJE",
        "first_name": "AGATHA",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-21",
        "last_updated": "2007-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35067956",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0121988",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lori M Christopher, C.N.P.
• Thomas Michael Chronister, LPCC-S
• Rebecca Ann Chuchanis
• Humayun Chughtai, MD
• Zenaida Alderette Chughtai, M.D.
• Cailin Chumita, CDCA, CT
• Ji Young Chung, DO
• Stephanie Rene Chuning
• Maria DO Carmo Ciasca, DDS. MSD.
• Anita Marie Ciccarelli, CNP, PMHNP

• Internal Medicine Physician in Canton, OH
• Providers in Canton, OH by specialty
• Internal Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.