Individual provider Active NPI

Sudhir Dubey, PSYD

  • Clinical Psychologist
  • Columbus, OH
National Provider Identifier
1609835768
Registry record updated Nov 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
4863 Issued in OH
Practice address
4612 Sawmill Rd
Columbus, OH 43220-2247
Phone
(614) 568-7101
Fax
(614) 568-7103
NPI assigned
Mar 18, 2006
Last updated
Nov 30, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 4863 OH Primary

Addresses

Primary practice location

4612 Sawmill Rd
Columbus, OH 43220-2247

Mailing address

4612 Sawmill Rd
Columbus, OH 43220-2247
Phone (614) 568-7101

Other identifiers 1

IdentifierTypeStateIssuer
0076630MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4863OHMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Addiction Services, LLC CurrentSince Mar 1, 2016 Accepting new patients
Arlington Injury Management LLC Current Accepting new patients
Buckeye Clinic PastSince Mar 1, 2021 Accepting new patients
Advanced Injury Management Clinical Past Accepting new patients
Linda Brashear MD, Inc. Past Accepting new patients

Locations

4612 Sawmill Rd
Columbus, OH 43220
Phone (614) 327-4338

484 S Miller Rd
Ste 201
Fairlawn, OH 44333
Phone (330) 835-4545

2816 W 1st St
Springfield, OH 45504
Phone (937) 322-8977

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1142640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480464000000",
    "number": "1609835768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4612 SAWMILL RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432202247",
            "telephone_number": "614-568-7101",
            "fax_number": "614-568-7103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4612 SAWMILL RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432202247",
            "telephone_number": "614-568-7101",
            "fax_number": "614-568-7103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBEY",
        "first_name": "SUDHIR",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-18",
        "last_updated": "2016-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "4863",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0076630",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2016; 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.