NPIMap

Organization Active NPI

ENT Central LLC

  • Otolaryngology Physician
  • Mansfield, OH
National Provider Identifier
1316225618
Registry record updated Dec 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
35.097400 Issued in OH
Legal business name
ENT CENTRAL LLC
Practice address
770 Balgreen Dr
Suite 209
Mansfield, OH 44906-4106
Phone
(419) 756-5500
Fax
(419) 756-5502
NPI assigned
Aug 3, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2011

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

Authorized official

Name
Mykola O Prykhodko, M.D.
Title
Owner/President
Phone
(419) 756-5500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X 35.097400 OH Primary

Addresses

Primary practice location

770 Balgreen Dr
Suite 209
Mansfield, OH 44906-4106

Mailing address

770 Balgreen Dr
Suite 209
Mansfield, OH 44906-4106
Phone (419) 756-5500

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1312329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323734400000",
    "number": "1316225618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 BALGREEN DR",
            "address_2": "SUITE 209",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449064106",
            "telephone_number": "419-756-5500",
            "fax_number": "419-756-5502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 BALGREEN DR",
            "address_2": "SUITE 209",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449064106",
            "telephone_number": "419-756-5500",
            "fax_number": "419-756-5502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENT CENTRAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-03",
        "last_updated": "2011-12-13",
        "status": "A",
        "authorized_official_last_name": "PRYKHODKO",
        "authorized_official_first_name": "MYKOLA",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "419-756-5500",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "OH",
            "license": "35.097400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 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.