NPIMap

Organization Active NPI

Buckeye Behavioral Health LLC

  • Psychiatry Physician
  • Canton, OH
National Provider Identifier
1275793028
Registry record updated Dec 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
35062816 Issued in OH
Legal business name
BUCKEYE BEHAVIORAL HEALTH LLC
Practice address
4888 Armandale Ave NW
Canton, OH 44718-2284
Phone
(330) 829-9389
Fax
(330) 829-9372
NPI assigned
Jun 16, 2008
Last updated
Dec 9, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2010

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

Authorized official

Name
Ranga R Thalluri, MDNPI 1467566745
Title
Psychiatry
Phone
(330) 829-9389

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 35062816 OH Primary

Addresses

Primary practice location

4888 Armandale Ave NW
Canton, OH 44718-2284

Mailing address

PO Box 2779
Alliance, OH 44601-0779
Phone (330) 829-9389

Other identifiers 1

IdentifierTypeStateIssuer
0987106MedicaidOH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1213574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291852800000",
    "number": "1275793028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2779",
            "city": "ALLIANCE",
            "state": "OH",
            "postal_code": "446010779",
            "telephone_number": "330-829-9389",
            "fax_number": "330-829-9372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4888 ARMANDALE AVE NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182284",
            "telephone_number": "330-829-9389",
            "fax_number": "330-829-9372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUCKEYE BEHAVIORAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-16",
        "last_updated": "2010-12-09",
        "status": "A",
        "authorized_official_last_name": "THALLURI",
        "authorized_official_first_name": "RANGA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PSYCHIATRY",
        "authorized_official_telephone_number": "330-829-9389",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35062816",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0987106",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.