NPIMap

Individual provider Active NPI

Charles V Kassicieh, DO

  • Emergency Medicine Physician
  • Dublin, OH
National Provider Identifier
1982660239
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
34004319K Issued in OH
Practice address
6724 Perimeter Loop Rd
Suite 202
Dublin, OH 43017-3202
Phone
(614) 975-5008
Fax
(614) 792-2400
NPI assigned
Apr 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 34004319K OH Primary

Addresses

Primary practice location

6724 Perimeter Loop Rd
Suite 202
Dublin, OH 43017-3202

Mailing address

6724 Perimeter Loop Rd
Suite 202
Dublin, OH 43017-3202
Phone (614) 975-5008

Other identifiers 1

IdentifierTypeStateIssuer
0670591MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
34004319KOHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Circleville Emergency Physicians Inc. Emergency Medicine Past Accepting new patients
Dublin Urgent Care Inc Past Accepting new patients
Mary Rutan Hospital Past Accepting new patients
Hocking Emergency Physicians Inc Emergency Medicine Past Accepting new patients
Bucyrus Emergency Physicians Inc Emergency Medicine Past Accepting new patients

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1982660239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6724 PERIMETER LOOP RD",
            "address_2": "SUITE 202",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430173202",
            "telephone_number": "614-975-5008",
            "fax_number": "614-792-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6724 PERIMETER LOOP RD",
            "address_2": "SUITE 202",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430173202",
            "telephone_number": "614-975-5008",
            "fax_number": "614-792-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASSICIEH",
        "first_name": "CHARLES",
        "middle_name": "V",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "34004319K",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0670591",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dublin, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.