Phoenix Dermatology LTD

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

PHOENIX DERMATOLOGY LTD

Practice address

4340 Fulton Road NW
Canton, OH 44718-2824

Phone

(330) 244-8886

Fax

(330) 244-8869

NPI assigned

Apr 11, 2006

Last updated

May 19, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Maria A Charif, MDNPI 1235106642

Title

Physician

Phone

(330) 244-8886

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Maria A Charif, MD

  • Dermatology Physician
  • Canton, OH
  • NPI 1235106642
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242691200000",
    "number": "1285697060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 155",
            "city": "CHESWICK",
            "state": "PA",
            "postal_code": "150240155",
            "telephone_number": "412-826-1065",
            "fax_number": "412-826-1491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4340 FULTON ROAD NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182824",
            "telephone_number": "330-244-8886",
            "fax_number": "330-244-8869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX DERMATOLOGY LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-11",
        "last_updated": "2009-05-19",
        "status": "A",
        "authorized_official_last_name": "CHARIF",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "330-244-8886",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charde Phillips
• Danita J Phillips
• Samyha Phillips
• Shane M Phillips, PHARMD, RPH
• Tristan Daniel Phillips
• Phoenix Rising Behavioral Healthcare and Recovery Inc (Phoenix Rising BHR)
• Phoenix Rising Behavioral Healthcare and Recovery, Inc
• Phoenix Rising Behavioral Healthcare and Recovery, Inc
• Kiran Phuloria, DO
• Physical Therapy Works, Inc.

• Specialist in Canton, OH
• Providers in Canton, OH by specialty
• Specialist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.