Suman K Mishr, MD

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

041221 Issued in OH

Practice address

306 Reichelderfer Rd
Cridersville, OH 45806-2252

Phone

(419) 645-4343

Fax

(419) 645-4443

NPI assigned

Sep 20, 2005

Reactivated

Apr 4, 2006

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 2

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

Interoperability endpoints

• Direct secure messaging: sumanmishr@glhs.allscriptsdirect.net

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.

• Suman K Mishr MD Inc

  • Internal Medicine Physician
  • Lima, OH
  • NPI 1952571713
  NPD (past) Authorized official
• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)
• Mercy Health-St Ritas Medical Center LLC

  • Endocrinology, Diabetes & Metabolism Physician
  • Lima, OH
  • NPI 1053365882
  NPD (past)
• Reema Taneja, M.D., Inc.

  • Internal Medicine Physician
  • Boardman, OH
  • NPI 1073667168

  Endocrinology, Diabetes & Metabolism

  NPD (past)
• RJ Healthcare

  • Internal Medicine Physician
  • Youngstown, OH
  • NPI 1346325651
  NPD (past)

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349049600000",
    "number": "1740276310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 REICHELDERFER RD",
            "city": "CRIDERSVILLE",
            "state": "OH",
            "postal_code": "458062252",
            "telephone_number": "419-645-4343",
            "fax_number": "419-645-4443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 REICHELDERFER RD",
            "city": "CRIDERSVILLE",
            "state": "OH",
            "postal_code": "458062252",
            "telephone_number": "419-645-4343",
            "fax_number": "419-645-4443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISHR",
        "first_name": "SUMAN",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2012-10-01",
        "deactivation_date": "2006-03-23",
        "reactivation_date": "2006-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "OH",
            "license": "041221",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI AFFILIATION",
            "identifier": "1053365882",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0360416",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Majestic Care of Cridersville LLC
• Lina Martin, DNP
• Theodore Adam Matheny
• Stephanie Rae Meyer
• Mishr Endocrinology & Diabetes Clinic LLC
• Amber Dawn Neumeier
• Katherine Nichols-Singer
• Otterbein Cridersville
• Otterbein Cridersville
• Perry TWP Trustees

• Endocrinology, Diabetes & Metabolism Physician in Cridersville, OH
• Providers in Cridersville, OH by specialty
• Endocrinology, Diabetes & Metabolism Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2012; 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.