NPIMap

Organization Active NPI

Innovative Mental Health Inc

  • Psychiatry Physician
  • Madison, OH
National Provider Identifier
1972747566
Registry record updated Jun 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
35087896 Issued in OH
Legal business name
INNOVATIVE MENTAL HEALTH INC
Practice address
65 N Lake St
Suite 100
Madison, OH 44057-3113
Phone
(440) 428-0055
Fax
(440) 428-0084
NPI assigned
Apr 27, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2011

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

Authorized official

Name
Sarbjot Singh Ajit, M.D.
Title
Billing Services
Phone
(440) 428-0055

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X 35087896 OH Primary

Addresses

Primary practice location

65 N Lake St
Suite 100
Madison, OH 44057-3113

Mailing address

65 N Lake St
Suite 100
Madison, OH 44057-3113
Phone (440) 428-0055

Other identifiers 1

IdentifierTypeStateIssuer
3147302MedicaidOH

National Provider Directory

National Provider Directory

Locations

65 N Lake St
#100
Madison, OH 44057
Phone (440) 428-0055

NPI Registry JSON

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

{
    "created_epoch": "1240790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308614400000",
    "number": "1972747566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 N LAKE ST",
            "address_2": "SUITE 100",
            "city": "MADISON",
            "state": "OH",
            "postal_code": "440573113",
            "telephone_number": "440-428-0055",
            "fax_number": "440-428-0084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 N LAKE ST",
            "address_2": "SUITE 100",
            "city": "MADISON",
            "state": "OH",
            "postal_code": "440573113",
            "telephone_number": "440-428-0055",
            "fax_number": "440-428-0084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE MENTAL HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-27",
        "last_updated": "2011-06-21",
        "status": "A",
        "authorized_official_last_name": "AJIT",
        "authorized_official_first_name": "SARBJOT",
        "authorized_official_middle_name": "SINGH",
        "authorized_official_title_or_position": "BILLING SERVICES",
        "authorized_official_telephone_number": "440-428-0055",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35087896",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3147302",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2011; 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.