Individual provider Active NPI

Priyabala Ramaiah, MD

  • Gynecology Physician
  • Canton, OH
National Provider Identifier
1770674947
Registry record updated Jan 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
35064484R Issued in OH
Practice address
1445 Harrison Ave NW
Suite 302
Canton, OH 44708-2620
Phone
(330) 452-9900
Fax
(330) 452-9945
NPI assigned
Sep 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 35064484R OH Primary

Addresses

Primary practice location

1445 Harrison Ave NW
Suite 302
Canton, OH 44708-2620

Mailing address

1445 Harrison Ave NW
Suite 302
Canton, OH 44708-2620
Phone (330) 452-9900

Other identifiers 1

IdentifierTypeStateIssuer
0925388MedicaidOH

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
I20031212000609 OH Practitioner - Obstetrics/Gynecology 9739086349 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35064484ROHMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ohio Physician Professional Corporation CurrentSince Aug 8, 2010 Accepting new patients

Locations

2600 6th St SW
Canton, OH 44710
Phone (330) 363-2180

2600 7th St SW
Canton, OH 44710
Phone (330) 363-6242

1020 Trump Rd NW
Ste 120
Carrollton, OH 44615
Phone (330) 627-3011

Organizations & group practices 1

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": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295913600000",
    "number": "1770674947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1445 HARRISON AVE NW",
            "address_2": "SUITE 302",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447082620",
            "telephone_number": "330-452-9900",
            "fax_number": "330-452-9945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1445 HARRISON AVE NW",
            "address_2": "SUITE 302",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447082620",
            "telephone_number": "330-452-9900",
            "fax_number": "330-452-9945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAMAIAH",
        "first_name": "PRIYABALA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2011-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "OH",
            "license": "35064484R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0925388",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.