Medcentral Professional Foundation, LLC

Primary specialty

Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X

Legal business name

MEDCENTRAL PROFESSIONAL FOUNDATION, LLC

Practice address

308 Glessner Avenue
Mansfield, OH 44903-2269

Phone

(419) 526-8962

Fax

(419) 526-8834

NPI assigned

Jan 18, 2008

Last updated

Sep 17, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Joseph L Chamberlain

Title

Ceo/Cfo

Phone

(419) 526-8000

Specialties & licenses 12

Addresses

Other identifiers 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Ohiohealth Corporation

  dba Doctors Hospital

  • General Acute Care Hospital
  • Columbus, OH
  • NPI 1972535052

  Member Of

  NPD member

Locations

Practitioners 60

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.

• Arun Acharekar, MD

  • Emergency Medicine Physician
  • Mansfield, OH
  • NPI 1659411544
  NPD (past)
• Mohammad A. Ahmed, D.O.

  • Emergency Medicine Physician
  • Kenton, OH
  • NPI 1376513838
  NPD (past)
• Martin Akusoba, M.D.

  • Emergency Medicine Physician
  • Upper Sandusky, OH
  • NPI 1811928302
  NPD (past)
• Heather Andrews, AU.D.

  • Audiologist
  • Mansfield, OH
  • NPI 1962958660
  NPD (past)
• Julie A Bonko, CCC-A

  • Audiologist
  • Mansfield, OH
  • NPI 1285667998
  NPD (past)
• Darrin L Bright, M.D.

  • Sports Medicine (Family Medicine) Physician
  • Columbus, OH
  • NPI 1760468920
  NPD (past)
• Khurram Butt, M.D.

  • Internal Medicine Physician
  • Dennison, OH
  • NPI 1437149176
  NPD (past)
• Philip E Calendine, MD

  • Diagnostic Radiology Physician
  • Mansfield, OH
  • NPI 1134233869
  NPD (past)
• James W Catalano, MD

  • Emergency Medicine Physician
  • Mansfield, OH
  • NPI 1003956996
  NPD (past)
• Bohdan Wolodymyr Chopko, PHD MD

  • Neurological Surgery Physician
  • Mansfield, OH
  • NPI 1932183332
  NPD (past)
• Dong S Chung, M.D.

  • Family Medicine Physician
  • Mansfield, OH
  • NPI 1205922325
  NPD (past)
• Anna M Cook, PA-C

  • Surgical Physician Assistant
  • Mansfield, OH
  • NPI 1295704062
  NPD (past)

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

{
    "created_epoch": "1200614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379376000000",
    "number": "1841476942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335 GLESSNER AVE",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449032269",
            "telephone_number": "419-526-8962",
            "fax_number": "419-526-8834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 GLESSNER AVENUE",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449032269",
            "telephone_number": "419-526-8962",
            "fax_number": "419-526-8834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDCENTRAL PROFESSIONAL FOUNDATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-18",
        "last_updated": "2013-09-17",
        "status": "A",
        "authorized_official_last_name": "CHAMBERLAIN",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO/CFO",
        "authorized_official_telephone_number": "419-526-8000"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "OH",
            "license": "35-07-2694-D",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "OH",
            "license": "35090672",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2810131",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Medcentral Health System
• Medcentral Health System (Mansfield Laboratory Services)
• Medcentral Homecare and Hospice
• Medcentral Homecare and Hospice
• Medcentral Professional Association Inc.
• Medella Counseling Services LLC (Medella Counseling Services)
• Medic Response Ambulance Service, Inc.
• Medical Arts Internists, Inc.
• Medical Information Technology Consultants (Urology Associates Facility)
• Medical Nanny

• Facial Plastic Surgery Physician in Mansfield, OH
• Providers in Mansfield, OH by specialty
• Facial Plastic Surgery Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2013; 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.