Organization Active NPI

Ohio Cancer Specialists

  • Hematology & Oncology Physician
  • Shelby, OH
National Provider Identifier
1639215114
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
Legal business name
OHIO CANCER SPECIALISTS
Practice address
31 E Main St
Suite 2
Shelby, OH 44875-1262
Phone
(419) 342-2775
Fax
(419) 342-2237
NPI assigned
Jan 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Donald Lee Dewald, M.D.
Title
President
Phone
(419) 342-2775

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RH0003X OH Primary

Addresses

Primary practice location

31 E Main St
Suite 2
Shelby, OH 44875-1262

Mailing address

371 Cline Ave
Mansfield, OH 44907-1021
Phone (419) 756-2122

Other identifiers 1

IdentifierTypeStateIssuer
2411170MedicaidOH

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1639215114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "371 CLINE AVE",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449071021",
            "telephone_number": "419-756-2122",
            "fax_number": "419-756-3530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 E MAIN ST",
            "address_2": "SUITE 2",
            "city": "SHELBY",
            "state": "OH",
            "postal_code": "448751262",
            "telephone_number": "419-342-2775",
            "fax_number": "419-342-2237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OHIO CANCER SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DEWALD",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "419-342-2775",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2411170",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.