NPIMap

Organization Active NPI

Advanced Dermatology and Skin Cancer Center

  • Clinical Medical Laboratory
  • Boardman, OH
National Provider Identifier
1497912893
Registry record updated May 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
35074029 Issued in OH
Legal business name
ADVANCED DERMATOLOGY AND SKIN CANCER CENTER
Practice address
987 Boardman Canfield Rd
Boardman, OH 44512-4222
Phone
(330) 965-8760
NPI assigned
May 22, 2008
Last updated
May 22, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2008

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

Authorized official

Name
Vicki Groner
Title
Billing Manager
Phone
(330) 965-8760

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 35074029 OH Primary

Addresses

Primary practice location

987 Boardman Canfield Rd
Boardman, OH 44512-4222

Mailing address

987 Boardman Canfield Rd
Boardman, OH 44512-4222
Phone (330) 965-8760

National Provider Directory

National Provider Directory

Locations

31 Stiles Rd
Ste 211
Salem, NH 03079

5817 Happy Hollow Rd
Milford, OH 45150
Phone (513) 327-9244

987 Boardman Canfield Rd
Youngstown, OH 44512
Phone (330) 271-8589

Practitioners & affiliated clinicians

Practitioners 69

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.

View all 69

NPI Registry JSON

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

{
    "created_epoch": "1211414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211414400000",
    "number": "1497912893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "987 BOARDMAN CANFIELD RD",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445124222",
            "telephone_number": "330-965-8760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "987 BOARDMAN CANFIELD RD",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445124222",
            "telephone_number": "330-965-8760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED DERMATOLOGY AND SKIN CANCER CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-22",
        "last_updated": "2008-05-22",
        "status": "A",
        "authorized_official_last_name": "GRONER",
        "authorized_official_first_name": "VICKI",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "330-965-8760"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "OH",
            "license": "35074029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boardman, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2008; 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.