Richard M Banozic, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

35067230 Issued in OH

Practice address

6847 N. Chestnut Street
Suite 310
Ravenna, OH 44266

Phone

(330) 296-2819

Fax

(330) 297-9503

NPI assigned

Sep 6, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)
• Partners Physician Group

  • Public Health & General Preventive Medicine Physician
  • Akron, OH
  • NPI 1164814414
  NPD (past)
• Vna Care Plus

  • Home Health Agency
  • Cleveland, OH
  • NPI 1750588356

  Internal Medicine

  NPD (past)

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

{
    "created_epoch": "1125964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419206400000",
    "number": "1487648408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6847 N. CHESTNUT STREET",
            "address_2": "SUITE 310",
            "city": "RAVENNA",
            "state": "OH",
            "postal_code": "44266",
            "telephone_number": "330-296-2819",
            "fax_number": "330-297-9503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6847 N. CHESTNUT STREET",
            "address_2": "SUITE 310",
            "city": "RAVENNA",
            "state": "OH",
            "postal_code": "44266",
            "telephone_number": "330-296-2819",
            "fax_number": "330-297-9503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANOZIC",
        "first_name": "RICHARD",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-06",
        "last_updated": "2014-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35067230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0985939",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TALLMADGE INTERNAL MEDICINE SPECIALISTS",
            "identifier": "1770896268",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS PHYSICIAN GROUP MEDICAID GROUP #",
            "identifier": "2551671",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS PHYSICIAN GROUP MEDICARE GROUP #",
            "identifier": "9338635",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS PHYSICIAN GROUP TYPE 2 NPI #",
            "identifier": "1841239274",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Badr K. Ghumrawi, M.D. Inc.
• Alexa Ann Baer
• Janet Bahle, CNS
• Timothy Darrell Baker
• Shanieka Bankston
• Merissa Viola Barber-Smith
• Paige Barber
• Kenneth Barkley
• Christy Barnes, CNP
• Bonnie Barnette

• Internal Medicine Physician in Ravenna, OH
• Providers in Ravenna, 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 Dec 22, 2014; 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.