Individual provider Active NPI

Barbara Shaw Cuddeback, MD

  • Psychiatry Physician
  • Toledo, OH
National Provider Identifier
1669540597
Registry record updated Oct 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
061414 Issued in GA
Practice address
3170 W Central Ave
Toledo, OH 43606
Phone
(567) 316-7253
NPI assigned
Nov 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 061414 GA Primary
Psychiatry Physician 2084P0800X ME97311 FL
Psychiatry Physician 2084P0800X 35085386 OH

Addresses

Primary practice location

3170 W Central Ave
Toledo, OH 43606

Mailing address

1 Elizabeth PL
Dayton, OH 45417-3445
Phone (567) 316-7253

Other practice location 1

930S Detroit Ave
Toledo, OH 43614-2701
Phone (419) 381-1881 ext. 4804

Other practice location 2

1 Elizabeth Pl
Dayton, OH 45417-3445
Phone (567) 316-7253

Other practice location 3

115 W McMicken Ave # Voa
Cincinnati, OH 45202-4915
Phone (567) 316-7253

Other identifiers 2

IdentifierTypeStateIssuer
2545008MedicaidOH
P01053073OtherFLMEDICARE RAILROAD PROVIDER NUMBER

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)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
061414GAMDPsychiatry Physician
35085386OHMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MCR Health, Inc. Past Accepting new patients
Harbor Psychiatry Past Accepting new patients
Ship Port Psych Services LLC Past Accepting new patients
Behavioral Health Services of South Georgia PastSince Mar 13, 2012 Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570060800000",
    "number": "1669540597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ELIZABETH PL",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454173445",
            "telephone_number": "567-316-7253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3170 W CENTRAL AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "43606",
            "telephone_number": "567-316-7253"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "930S DETROIT AVE",
            "address_purpose": "LOCATION",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436142701",
            "country_code": "US",
            "telephone_number": "419-381-1881 x4804",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Elizabeth Pl",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454173445",
            "country_code": "US",
            "telephone_number": "567-316-7253",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "115 W McMicken Ave # Voa",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452024915",
            "country_code": "US",
            "telephone_number": "567-316-7253",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUDDEBACK",
        "first_name": "BARBARA",
        "middle_name": "SHAW",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-30",
        "last_updated": "2019-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "061414",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME97311",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35085386",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2545008",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD PROVIDER NUMBER",
            "identifier": "P01053073",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2019; 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.