Organization Active NPI

Richland Pulmonary and Critical Care Associates Inc

  • Pulmonary Disease Physician
  • Mansfield, OH
National Provider Identifier
1962494302
Registry record updated Aug 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
RICHLAND PULMONARY AND CRITICAL CARE ASSOCIATES INC
Practice address
391 Glessner Ave
Mansfield, OH 44903-2107
Phone
(419) 524-8250
Fax
(419) 524-6164
NPI assigned
Aug 22, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2010

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

Authorized official

Name
Mr. Sunil J Vaidva, MD
Title
Vice President
Phone
(419) 524-8250

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RP1001X Primary

Addresses

Primary practice location

391 Glessner Ave
Mansfield, OH 44903-2107

Mailing address

391 Glessner Ave
Mansfield, OH 44903-2107
Phone (419) 524-8250

Other identifiers 1

IdentifierTypeStateIssuer
2196609MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101116000302 OH Part B Supplier - Clinic/Group Practice 0941495964 Receives reassigned benefits from 1 practitioner
Practice locations: Mansfield, OH

National Provider Directory

National Provider Directory

Locations

391 Glessner Ave
Ste A
Mansfield, OH 44903
Phone (419) 524-8250

391 Glessner Ave
Mansfield, OH 44903
Phone (419) 524-8250

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282694400000",
    "number": "1962494302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "391 GLESSNER AVE",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449032107",
            "telephone_number": "419-524-8250",
            "fax_number": "419-524-6164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "391 GLESSNER AVE",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449032107",
            "telephone_number": "419-524-8250",
            "fax_number": "419-524-6164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHLAND PULMONARY AND CRITICAL CARE ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-22",
        "last_updated": "2010-08-25",
        "status": "A",
        "authorized_official_last_name": "VAIDVA",
        "authorized_official_first_name": "SUNIL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "419-524-8250",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2196609",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.