Pancharathna K Athmaram, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

35051805 Issued in OH

Practice address

661 Park Ave E
Suite a
Mansfield, OH 44905-2880

Phone

(419) 526-3999

Fax

(419) 526-1137

NPI assigned

Sep 6, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1125964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256083200000",
    "number": "1164416210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "661 PARK AVE E",
            "address_2": "SUITE A",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449052880",
            "telephone_number": "419-526-3999",
            "fax_number": "419-526-1137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "661 PARK AVE E",
            "address_2": "SUITE A",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449052880",
            "telephone_number": "419-526-3999",
            "fax_number": "419-526-1137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATHMARAM",
        "first_name": "PANCHARATHNA",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-06",
        "last_updated": "2009-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35051805",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0585424",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110188865",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ashlee Christine Ault
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• Internal Medicine Physician in Mansfield, OH
• Providers in Mansfield, 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 Oct 21, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.