Soroush Shakibakho, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

35.150765 Issued in OH

Practice address

6046 Whipple Ave NW
North Canton, OH 44720-7616

Phone

(330) 433-1311

Fax

(330) 477-7783

NPI assigned

Jul 13, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Family Practice

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• Aultman Hospital Hospital, Canton, OH, CCN 360084

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Aultman Hospital

  • General Acute Care Hospital
  • Canton, OH
  • NPI 1356366991
  Care Compare affiliation

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

{
    "created_epoch": "1626134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1326610015",
    "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": "447080690",
            "telephone_number": "330-363-7444",
            "fax_number": "330-363-7770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6046 WHIPPLE AVE NW",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447207616",
            "telephone_number": "330-433-1311",
            "fax_number": "330-477-7783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAKIBAKHO",
        "first_name": "SOROUSH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-13",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35.150765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• J Larry Shafer, O.D.
• Courtney E Shaffer, PTA
• Shannon Shaffer
• Kalindi Shah, PTA
• Taylor Shahan
• Ali Shakir, MD
• Gavin Shannon, PTA
• Sharad H. Bhatt MD, Inc
• Kristen Shaub, DO
• Lauren A Shaub, PT, DPT

• Family Medicine Physician in North Canton, OH
• Providers in North Canton, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.