Organization Active NPI

Central Ohio Neurology Inc

  • Neurology Physician
  • Mansfield, OH
National Provider Identifier
1619010535
Registry record updated Aug 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
CENTRAL OHIO NEUROLOGY INC
Practice address
370 Cline Avenue
Ste C5
Mansfield, OH 44907-1057
Phone
(419) 756-6990
Fax
(419) 756-0944
NPI assigned
Feb 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2012

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

Authorized official

Name
Dr. Raymond J Baddour, MD
Title
Owner
Phone
(419) 756-6990

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X Primary

Addresses

Primary practice location

370 Cline Avenue
Ste C5
Mansfield, OH 44907-1057

Mailing address

370 Cline Ave
Ste C5
Mansfield, OH 44907-1057
Phone (419) 756-6990

Other identifiers 4

IdentifierTypeStateIssuer
2877801MedicaidOH
606176800OtherOHDEPT OF LABOR ID
30022664OtherOHRAILROAD MEDICARE
000000182209OtherOHANTHEM

National Provider Directory

National Provider Directory

Locations

370 Cline Ave
Ste C5
Mansfield, OH 44907
Phone (419) 564-4353

370 Cline Ave
Ste C8
Mansfield, OH 44907
Phone (419) 756-6990

NPI Registry JSON

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346025600000",
    "number": "1619010535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "370 CLINE AVE",
            "address_2": "STE C5",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449071057",
            "telephone_number": "419-756-6990",
            "fax_number": "419-756-0944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 CLINE AVENUE",
            "address_2": "STE C5",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449071057",
            "telephone_number": "419-756-6990",
            "fax_number": "419-756-0944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL OHIO NEUROLOGY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-14",
        "last_updated": "2012-08-27",
        "status": "A",
        "authorized_official_last_name": "BADDOUR",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "419-756-6990",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2877801",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR ID",
            "identifier": "606176800",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "30022664",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000182209",
            "state": "OH"
        }
    ],
    "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 Aug 27, 2012; 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.