Individual provider Active NPI

Lakshmi Narayana Potakamuri, M.D.

  • Internal Medicine Physician
  • Canton, OH
National Provider Identifier
1528394269
Registry record updated Jul 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35.132749 Issued in OH
Practice address
1330 Mercy Dr NW Ste 101
Canton, OH 44708-2624
Phone
(330) 588-4676
Fax
(330) 588-4677
NPI assigned
Oct 31, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 17589 NH
Internal Medicine Physician 207R00000X 35.132749 OH Primary

Addresses

Primary practice location

1330 Mercy Dr NW Ste 101
Canton, OH 44708-2624

Mailing address

1330 Mercy Dr NW Ste 101
Canton, OH 44708-2624
Phone (330) 588-4676

Other practice location 1

1320 Mercy Dr NW
Canton, OH 44708-2614
Phone (330) 489-1000

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20210506001993 OH Practitioner - Cardiovascular Disease (Cardiology) 0547449266 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Professional Care, LLCGroup PAC ID 7416857198, 53 clinicians
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

1330 Mercy Dr NW
Suite 101
Canton, OH 44708-2624
Phone (330) 588-4676

9500 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-5433

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Professional Care, LLC Internal Medicine CurrentSince May 1, 2021 Accepting new patients
The Cleveland Clinic Foundation CurrentSince Nov 9, 2022 Accepting new patients

Locations

1320 Timken Mercy Dr NW
Canton, OH 44708
Phone (330) 489-1000

1330 Mercy Dr NW
Ste 101
Canton, OH 44708
Phone (330) 244-8505

1330 Mercy Dr NW
Ste 319
Canton, OH 44708
Phone (330) 580-4706

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363

Organizations & group practices 2

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1256947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627430400000",
    "number": "1528394269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 MERCY DR NW STE 101",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447082624",
            "telephone_number": "330-588-4676",
            "fax_number": "330-588-4677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 MERCY DR NW STE 101",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447082624",
            "telephone_number": "330-588-4676",
            "fax_number": "330-588-4677"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1320 Mercy Dr NW",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "OH",
            "postal_code": "447082614",
            "country_code": "US",
            "telephone_number": "330-489-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POTAKAMURI",
        "first_name": "LAKSHMI",
        "middle_name": "NARAYANA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-31",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NH",
            "license": "17589",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.132749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.