Active NPI
Mark N Casdorph, D.O.
- Child & Adolescent Psychiatry Physician
- Troy, OH
National Provider Identifier
1104870955
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- 34.007158
- Practice address
- 3130 N County Road 25a
Troy, OH 45373-1337 - Phone
- (937) 440-7305
- Fax
- (937) 440-7702
- NPI assigned
- May 19, 2006
- Last updated
- Jul 21, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 1322 | WV | |
| Child & Adolescent Psychiatry Physician | 2084P0804X | 34.007158 | OH | Primary |
Addresses
Primary practice location
3130 N County Road 25a
Troy, OH 45373-1337
Mailing address
3170 Kettering Blvd BLDG B3
Moraine, OH 45439-1924
Phone (937) 991-3188
Other practice location 1
3375 US RT 60 E
Huntington, WV 25705-2837
Phone (304) 525-7851 ext. 1449
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lima Memorial Joint Operating Company | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Lima Memorial Health System
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1104870955",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3170 KETTERING BLVD BLDG B3",
"city": "MORAINE",
"state": "OH",
"postal_code": "454391924",
"telephone_number": "937-991-3188",
"fax_number": "937-223-9811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3130 N COUNTY ROAD 25A",
"city": "TROY",
"state": "OH",
"postal_code": "453731337",
"telephone_number": "937-440-7305",
"fax_number": "937-440-7702"
}
],
"practiceLocations": [
{
"address_1": "3375 US RT 60 E",
"address_purpose": "LOCATION",
"city": "Huntington",
"state": "WV",
"postal_code": "257052837",
"country_code": "US",
"telephone_number": "304-525-7851 x1449",
"fax_number": "304-586-0671",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CASDORPH",
"first_name": "MARK",
"middle_name": "N",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-19",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "WV",
"license": "1322",
"primary": false
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "OH",
"license": "34.007158",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Troy, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.