Osamuedemen Iyoha, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

35-134151 Issued in OH

Practice address

625 Cleveland Ave NW
Canton, OH 44702-1805

Phone

(330) 445-2677

Fax

(330) 455-2101

NPI assigned

Apr 7, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH, MI2 enrollments

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 2

Specialty

Psychiatry

Education

Wayne State University School of Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Commquest Services, Inc.Group PAC ID 9335110824, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Commquest Services, Inc.

  • Multi-Specialty Clinic/Center
  • Canton, OH
  • NPI 1730168311
  Medicare reassignment Care Compare group NPD
• McLaren Northern Michigan

  • Family Medicine Physician
  • Petoskey, MI
  • NPI 1760736094
  Medicare reassignment NPD
• Team Wellness Center

  • Community Health Clinic/Center
  • Detroit, MI
  • NPI 1588855100
  Medicare reassignment NPD
• Victory Care Clinic

  • Psychiatry Physician
  • Wayne, MI
  • NPI 1184377236
  NPD Authorized official
• Victory Care Clinic

  • Adult Mental Health Clinic/Center
  • Wayne, MI
  • NPI 1770291791
  NPD Authorized official
• Commquest Services, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Canton, OH
  • NPI 1841550696
  NPD
• McLaren Northern Michigan

  • Psychiatric Hospital Unit
  • Cheboygan, MI
  • NPI 1336897735
  NPD
• Team Mental Health Services Inc.

  • Primary Care Clinic/Center
  • Detroit, MI
  • NPI 1295324291
  NPD

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

{
    "created_epoch": "1428364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1144616079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 CLEVELAND AVE NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447021805",
            "telephone_number": "330-455-0374",
            "fax_number": "330-453-6716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 CLEVELAND AVE NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447021805",
            "telephone_number": "330-445-2677",
            "fax_number": "330-455-2101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "130 1st St NW",
            "address_purpose": "LOCATION",
            "city": "Massillon",
            "state": "OH",
            "postal_code": "446475452",
            "country_code": "US",
            "telephone_number": "330-833-0234",
            "fax_number": "330-837-7705",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1207 W State St Ste M",
            "address_purpose": "LOCATION",
            "city": "Alliance",
            "state": "OH",
            "postal_code": "446014686",
            "country_code": "US",
            "telephone_number": "330-821-8407",
            "fax_number": "330-821-8506",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1110 Eldon Baker Dr",
            "address_purpose": "LOCATION",
            "city": "Flint",
            "state": "MI",
            "postal_code": "485071923",
            "country_code": "US",
            "telephone_number": "810-742-4968",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IYOHA",
        "first_name": "OSAMUEDEMEN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-07",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301116992",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35-134151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Bernadette Jabour, DO

• Psychiatry Physician in Canton, OH
• Providers in Canton, OH by specialty
• Psychiatry Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2024; 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.