Samuel L Hissong, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

35 030121 Issued in OH

Practice address

5423 Peninsula Dr NW
Canton, OH 44718-1633

Phone

(330) 904-8716

NPI assigned

Nov 2, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Radiology Associates of Canton, Inc.

  • Diagnostic Radiology Physician
  • Canton, OH
  • NPI 1912982034
  NPD (past)

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1639160260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5423 PENINSULA DR NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447181633",
            "telephone_number": "330-904-8716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5423 PENINSULA DR NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447181633",
            "telephone_number": "330-904-8716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HISSONG",
        "first_name": "SAMUEL",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "OH",
            "license": "35030121",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "35 030121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Hiploylee, M.D.
• Chelsae Hipp, CT 1500102
• Steven C Hirsch, M.D.
• Guy Brian Hisrich, DDS
• Rita Hissner, LPN
• Nicole Grace Hitchings
• Kristen Rachael Hites, LPN
• Wendy E Hixenbaugh
• Pauline Marie Hlad, P.T.
• Haley Danielle Hlavaty, D.O

• Diagnostic Radiology Physician in Canton, OH
• Providers in Canton, OH by specialty
• Diagnostic Radiology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2023; 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.