NPIMap

Organization Active NPI

Comprehensive Skin Cancer Center

  • Dermatology Physician
  • Columbus, OH
National Provider Identifier
1821329616
Registry record updated Jan 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
BR9944732 Issued in OH
Legal business name
COMPREHENSIVE SKIN CANCER CENTER
Practice address
1339 La Rochelle Dr
Columbus, OH 43221-1531
Phone
(917) 836-5771
NPI assigned
Jan 19, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2010

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

Authorized official

Name
George Khabenskiy
Title
Business Manager
Phone
(917) 836-5771

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X BR9944732 OH Primary

Addresses

Primary practice location

1339 La Rochelle Dr
Columbus, OH 43221-1531

Mailing address

600 Morrison Rd
Gahanna, OH 43230-5342

National Provider Directory

National Provider Directory

Locations

600 Morrison Rd
Gahanna, OH 43230

NPI Registry JSON

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

{
    "created_epoch": "1263859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263859200000",
    "number": "1821329616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 MORRISON RD",
            "city": "GAHANNA",
            "state": "OH",
            "postal_code": "432305342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1339 LA ROCHELLE DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432211531",
            "telephone_number": "917-836-5771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPREHENSIVE SKIN CANCER CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-19",
        "last_updated": "2010-01-19",
        "status": "A",
        "authorized_official_last_name": "KHABENSKIY",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "917-836-5771"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "OH",
            "license": "BR9944732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2010; 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.