Active NPI
Charles Ronald Smalling Jr., MD
- Dermatology Physician
- Athens, OH
National Provider Identifier
1144203092
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 35.088883
- Practice address
- 2131 E State St
Athens, OH 45701-2138 - Phone
- (740) 589-3100
- Fax
- (740) 566-4049
- NPI assigned
- Nov 23, 2005
- 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 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 01055546A | IN | |
| Dermatology Physician | 207N00000X | 27830 | SC | |
| Dermatopathology Physician | 207ND0900X | 27830 | SC | |
| Procedural Dermatology Physician | 207NS0135X | 01055546A | IN | |
| Procedural Dermatology Physician | 207NS0135X | 27830 | SC | |
| Dermatology Physician | 207N00000X | 35.088883 | OH | Primary |
Addresses
Primary practice location
2131 E State St
Athens, OH 45701-2138
Mailing address
90 Jackson Pike
Gallipolis, OH 45631-1560
Phone (740) 589-3100
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2723815 | Medicaid | OH | |
| 3810007810 | Medicaid | WV | |
| 2723815 | Other | OH | OH MEDICAID MOLINA |
| P00362716 | Other | OH | RAILROAD MEDICARE |
| 000000204802 | Other | OH | OH MEDICAID UNISON |
| 310917085159 | Other | OH | OH MEDICAID CARESOURCE |
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27830 | SC | MD | Registered Nurse |
| 35.088883 | OH | MD | Dermatology Physician |
| 01055546A | IN | MD | Procedural Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132704000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1423440000000",
"number": "1144203092",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "90 JACKSON PIKE",
"city": "GALLIPOLIS",
"state": "OH",
"postal_code": "456311560",
"telephone_number": "740-589-3100",
"fax_number": "740-566-4049"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2131 E STATE ST",
"city": "ATHENS",
"state": "OH",
"postal_code": "457012138",
"telephone_number": "740-589-3100",
"fax_number": "740-566-4049"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMALLING",
"first_name": "CHARLES",
"middle_name": "RONALD",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-23",
"last_updated": "2015-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "IN",
"license": "01055546A",
"primary": false
},
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "SC",
"license": "27830",
"primary": false
},
{
"code": "207ND0900X",
"taxonomy_group": "",
"desc": "Dermatology, Dermatopathology",
"state": "SC",
"license": "27830",
"primary": false
},
{
"code": "207NS0135X",
"taxonomy_group": "",
"desc": "Dermatology, Procedural Dermatology",
"state": "IN",
"license": "01055546A",
"primary": false
},
{
"code": "207NS0135X",
"taxonomy_group": "",
"desc": "Dermatology, Procedural Dermatology",
"state": "SC",
"license": "27830",
"primary": false
},
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "OH",
"license": "35.088883",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2723815",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3810007810",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OH MEDICAID MOLINA",
"identifier": "2723815",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00362716",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OH MEDICAID UNISON",
"identifier": "000000204802",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OH MEDICAID CARESOURCE",
"identifier": "310917085159",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Athens, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.