NICHOLAS SOUSARIS (NPI# 1417367285) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417367285 |
| Entity Type | Individual |
| Full Name | NICHOLAS SOUSARIS |
| Credential | MD |
| Practice Address |
4881 Sugar Maple Dr Bldg 830 Wright Patterson Afb OH 45433-5529 |
| Practice Telephone | 9372570837 |
| Enumeration Date | 2014-05-02 |
| Last Update Date | 2019-07-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
01082210A | IN | Allopathic & Osteopathic Physicians |
| Street Address |
4881 SUGAR MAPLE DR BLDG 830 |
| City | WRIGHT PATTERSON AFB |
| State | OH |
| Zip Code | 45433-5529 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588645428 | Steven Lawrence Pope | Nurse Anesthetist, Certified Registered | 4881 Sugar Maple Dr Bldg 830, Wright Patterson Afb, OH 45433-5529 | 2005-11-08 |
| 1225595879 | Beverley Sue Knight-stukenborg | Social Worker | 4881 Sugar Maple Dr Bldg 830, Wright Patterson Afb, OH 45433-5529 | 2019-03-01 |
| 1528460219 | Sarah R Dekoski | Physician Assistant | 4881 Sugar Maple Dr Bldg 830, Wright Patterson Afb, OH 45433-5529 | 2014-09-24 |
| 1487071957 | Luke Menner | Internal Medicine | 4881 Sugar Maple Dr Bldg 830, Wright Patterson Afb, OH 45433-5529 | 2014-03-24 |
| 1487078887 | David Geottman | Internal Medicine | 4881 Sugar Maple Dr Bldg 830, Wright Patterson Afb, OH 45433-5529 | 2014-02-06 |
| 1356696595 | Christopher Robert Wild | Student in an Organized Health Care Education/Training Program | 4881 Sugar Maple Dr Bldg 830, Wright Patterson Afb, OH 45433-5529 | 2012-07-13 |
| 1518224872 | Matthew Thomas Koroscil | Internal Medicine | 4881 Sugar Maple Dr Bldg 830, Wright Patterson Afb, OH 45433-5529 | 2012-04-11 |
| 1053632000 | Melissa Candella Holt | Dentist | 4881 Sugar Maple Dr Bldg 830, Wright Patterson Afb, OH 45433-5529 | 2010-06-14 |
| 1114129426 | Denise A Lockhart | Dietitian, Registered | 4881 Sugar Maple Dr Bldg 830, Wright Patterson Afb, OH 45433-5529 | 2007-05-31 |
| 1033285200 | Matthew Ray Doubrava | Preventive Medicine | 4881 Sugar Maple Dr Bldg 830, Wright Patterson Afb, OH 45433-5529 | 2006-11-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891289518 | Sara Lyons | Physician Assistant | 88 Mdj/sghj, 4881 Sugar Maple Dr, Wright-patterson Afb, OH 45433 | 2018-06-16 |
| 1073001558 | Mega Margapuram | Student in an Organized Health Care Education/Training Program | 1 Sugar Maple Drive, Dayton, OH 45433 | 2018-04-30 |
| 1437667979 | Michael Peter Dring | Social Worker | Building 830, Credentials Office, 4881 Sugar Maple Rd, Wpafb, OH 45433 | 2018-01-18 |
| 1316486814 | Josiah Hardin | Internal Medicine | 88 Mdos/sgomi, 4881 Sugar Maple Dr., Wright-patterson Afb, OH 45433 | 2017-02-16 |
| 1780137380 | Allison Osterfeld | Pharmacist | 88 Mdg 4881 Suga Maple Dr, Wright Patterson Afb, OH 45433 | 2016-07-29 |
| 1891144283 | Kyle Harris | Student in an Organized Health Care Education/Training Program | 4481 Sugar Maple Dr., Wright Patterson Afb, OH 45433 | 2016-06-07 |
| 1245601756 | Nichole Griep | Audiologist | 88 Mdg/sgpq, 4881 Sugar Maple Dr, Wright-patterson Afb, OH 45433 | 2015-10-09 |
| 1487021267 | Melanie Schaffer | Dietitian, Registered | 4881 Sugamaple Drive, Wpafb, OH 45433 | 2015-08-27 |
| 1831582261 | Joseph K Wray | General Practice | 88 Mdg/sgcj, 4881 Sugar Maple Dr., Wright-patterson Afb, OH 45433 | 2015-03-10 |
| 1659798031 | Maninder Kaur | Nurse Practitioner | 88 Mdos/sgom, 4881 Sugar Maple Drive, Wright Patterson Afb, OH 45433 | 2014-03-24 |
| Find all providers in zip 45433 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104812882 | Delano Donald Wilson | Radiology | 4881 Sugarmaple Dr, Bldg 830, 88th Dts/sgqx, Wright Patterson Medical Center, Wright Patterson Afb, OH 45433-5529 | 2005-09-27 |
| 1679712251 | Weston Tyler Winkler | Radiology | 88 Mdg, 4881 Sugar Maple Drive, Wright Patterson Afb, OH 45433 | 2009-02-05 |
| 1457349458 | Jon K. Marti | Radiology | 4881 Sugar Maple Dr, Wright Patterson Afb, OH 45433-5529 | 2005-10-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326645813 | Lumina Imaging | Radiology | 8401 Mentor Ave Ste B, Mentor, OH 44060-5843 | 2020-10-07 |
| 1700490943 | Katrina Overbey | Radiology | 4604 Northridge Dr, Batavia, OH 45103-1329 | 2020-09-04 |
| 1235752981 | Infinity Teleradiology LLC | Radiology | 17365 Lookout Dr, Chagrin Falls, OH 44023-2135 | 2020-05-28 |
| 1811481120 | Northern Ohio Medical Specialists LLC | Radiology | 2800 Hayes Ave Bldg C130, Sandusky, OH 44870-7248 | 2018-06-20 |
| 1922528595 | Advantage Imaging, LLC | Radiology | 1120 Polaris Pkwy Ste 105, Columbus, OH 43240-4042 | 2017-06-23 |
| 1568845279 | Rod Momenian | Radiology | 9500 Euclid Ave # Oh44195, Cleveland, OH 44195-1716 | 2015-06-30 |
| 1356756159 | Jerald Eckman | Radiology | 8645 Mallard Cir, Plain City, OH 43064-6004 | 2014-07-01 |
| 1770995854 | Proscan Womens Imaging At Redbank LLC | Radiology | 11594 Springfield Pike, Suite 26, Cincinnati, OH 45246-3527 | 2014-05-23 |
| 1104248467 | Mobile X Ray Express, LLC | Radiology | 1020 Township Road 145, Ironton, OH 45638-8593 | 2014-01-06 |
| 1356762074 | Edwin Robert Payne | Radiology | 465 Overlook Dr Ne, Lancaster, OH 43130-1918 | 2013-12-23 |
| Find all providers with the same taxonomy | ||||
| City | WRIGHT PATTERSON AFB |
| Zip Code | 45433 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.