Active NPI
Sudheer R Shirali, MD
- Pediatrics Physician
- North Canton, OH
National Provider Identifier
1093821548
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 35035193
- Practice address
- 4900 Frank Rd NW
North Canton, OH 44720 - Phone
- (330) 494-9797
- Fax
- (330) 499-1241
- NPI assigned
- Aug 21, 2006
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 35035193 | OH | Primary |
Addresses
Primary practice location
4900 Frank Rd NW
North Canton, OH 44720
Mailing address
PO Box 80690
Canton, OH 44708
Phone (330) 833-5530
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0198727 | 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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35035193 | OH | MD | Pediatrics Physician |
Interoperability endpoints
- sudheer.shirali.1@16705.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317859200000",
"number": "1093821548",
"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": "4900 FRANK RD NW",
"city": "NORTH CANTON",
"state": "OH",
"postal_code": "44720",
"telephone_number": "330-494-9797",
"fax_number": "330-499-1241"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIRALI",
"first_name": "SUDHEER",
"middle_name": "R",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-21",
"last_updated": "2011-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "OH",
"license": "35035193",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0198727",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in North Canton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.