Active NPI
Robert N Disimone, MD
- Nuclear Radiology Physician
- North Canton, OH
National Provider Identifier
1154312874
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nuclear Radiology Physician
- License
- 35 02 6612
- Practice address
- 2465 Oakway St NW
North Canton, OH 44720-5886 - Phone
- (330) 494-9541
- Fax
- (330) 494-9540
- NPI assigned
- Nov 2, 2005
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nuclear Radiology Physician | 2085N0904X | 35 02 6612 | OH | Primary |
| Diagnostic Radiology Physician | 2085R0202X | 35 02 6612 | OH | |
| In Vivo & In Vitro Nuclear Medicine Physician | 207UN0903X | 35.026612 | OH |
Addresses
Primary practice location
2465 Oakway St NW
North Canton, OH 44720-5886
Mailing address
2465 Oakway St NW
North Canton, OH 44720-5886
Phone (330) 494-9541
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0302354 | 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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35.026612 | OH | MD | In Vivo & In Vitro Nuclear Medicine Physician |
| 35 02 6612 | OH | MD | Nuclear Radiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1190678400000",
"number": "1154312874",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2465 OAKWAY ST NW",
"city": "NORTH CANTON",
"state": "OH",
"postal_code": "447205886",
"telephone_number": "330-494-9541",
"fax_number": "330-494-9540"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2465 OAKWAY ST NW",
"city": "NORTH CANTON",
"state": "OH",
"postal_code": "447205886",
"telephone_number": "330-494-9541",
"fax_number": "330-494-9540"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DISIMONE",
"first_name": "ROBERT",
"middle_name": "N",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-02",
"last_updated": "2007-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "2085N0904X",
"taxonomy_group": "",
"desc": "Radiology, Nuclear Radiology",
"state": "OH",
"license": "35 02 6612",
"primary": true
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "OH",
"license": "35 02 6612",
"primary": false
},
{
"code": "207UN0903X",
"taxonomy_group": "",
"desc": "Nuclear Medicine, In Vivo & In Vitro Nuclear Medicine",
"state": "OH",
"license": "35.026612",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0302354",
"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 Sep 25, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.