CENTRAL OHIO NEUROLOGY INC (NPI# 1619010535) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619010535 |
| Entity Type | Organization |
| Organization Name | CENTRAL OHIO NEUROLOGY INC |
| Practice Address |
370 Cline Avenue Ste C5 Mansfield OH 44907-1057 |
| Mailing Address |
370 Cline Ave Ste C5 Mansfield OH 44907-1057 |
| Practice Telephone | 4197566990 |
| Practice Fax Number | 4197560944 |
| Mailing Telephone | 4197566990 |
| Mailing Fax Number | 4197560944 |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2012-08-27 |
| Authorized Official Name | DR. RAYMOND J BADDOUR (OWNER) |
| Authorized Official Telephone | 4197566990 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | DEPT OF LABOR ID | 606176800 | 01 |
| OH | 2877801 | 05 | |
| OH | ANTHEM | 000000182209 | 01 |
| OH | RAILROAD MEDICARE | 30022664 | 01 |
| Street Address |
370 CLINE AVENUE STE C5 |
| City | MANSFIELD |
| State | OH |
| Zip Code | 44907-1057 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982623583 | Charles H Shaw | Specialist | 370 Cline Avenue, Mansfield, OH 44907 | 2006-07-18 |
| 1881898880 | Donald Daniel Degenso | Dentist | 370 Cline Avenue, Mansfield, OH 44907-1057 | 2007-06-13 |
| 1609097955 | Morris Walter Wasylenki | Dentist | 370 Cline Avenue, Mansfield, OH 44907 | 2007-05-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053932434 | Kerri Nichole Tolliver | Licensed Practical Nurse | Mansfield Comprehensive Treatment Center, 475 Lexington Ave, Mansfield, OH 44907 | 2020-04-27 |
| 1790325371 | Gabrielle Smith | Licensed Practical Nurse | 707 Scholl Rd, Mansfield, OH 44907 | 2020-01-10 |
| 1912544982 | Heidi L Mathews | Behavior Technician | 270 Sterkel Blvd., Mansfield, OH 44907 | 2019-12-09 |
| 1851942254 | Misty J Kline | Licensed Practical Nurse | 707 Scholl Rd., Mansfield, OH 44907 | 2019-09-26 |
| 1528533320 | Ohio Treatment Center, LLC | Clinic/Center | 475 Lexington Ave., Mansfield, OH 44907 | 2018-10-08 |
| 1750898722 | Hannah Rose Hardin | Behavior Technician | 1033 Larchwood R, Mansfield, OH 44907 | 2017-12-29 |
| 1932548856 | Jessica Alexis Taylor | Counselor | 641 Scholl Rd., Mansfield, OH 44907 | 2013-06-25 |
| 1336495258 | Sonal Sinha | Psychiatry & Neurology | 341 Cline Ave Ste 1, Mansfield, OH 44907 | 2012-07-29 |
| 1427321579 | Tara Kightlinger | Community Health Worker | 442 Brenda Dr, Mansfield, OH 44907 | 2012-02-21 |
| 1649557620 | William Scott Olar | Chiropractor | 1179 Lexington Ave, Mansfield, OH 44907 | 2011-11-04 |
| Find all providers in zip 44907 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881725075 | Donna Ellen Newsome | Psychiatry & Neurology | 900 N Walnut Creek Dr, Ste. 100#211, Mansfield, TX 76063-8046 | 2007-03-08 |
| 1225132277 | Donna Ellen Newsome | Psychiatry & Neurology | 2364 N. Hwy 287, Suite 119, Mansfield, TX 76063 | 2006-09-12 |
| 1598752701 | Mansfield Neurology Inc | Psychiatry & Neurology | 222 Marion Ave, Mansfield, OH 44903-2138 | 2005-10-03 |
| 1114367786 | Suraj Rajan | Psychiatry & Neurology | 335 Glessner Ave, Mansfield, OH 44903-2269 | 2013-06-27 |
| 1144541202 | Magdala Poon | Psychiatry & Neurology | 2800 E Broad St, Suite 504, Mansfield, TX 76063-6409 | 2010-06-11 |
| 1043338312 | Neurology Associates of Arlington, P.a. | Psychiatry & Neurology | 2800 E Broad St, Suite 504, Mansfield, TX 76063-6409 | 2007-03-26 |
| 1750430419 | Roberto M Nieto | Psychiatry & Neurology | 2800 E Broad St, Suite 504, Mansfield, TX 76063-6409 | 2007-01-10 |
| 1205985934 | Robert E Mcmichael | Psychiatry & Neurology | 2800 E Broad St, Suite 504, Mansfield, TX 76063-6409 | 2007-01-10 |
| 1891844577 | Ganana Tesfa | Psychiatry & Neurology | 2800 E Broad St, Suite 504, Mansfield, TX 76063 | 2007-01-10 |
| 1508875634 | Raymond Joseph Baddour | Psychiatry & Neurology | 370 Cline Ave, Ste C5, Mansfield, OH 44907-1057 | 2006-08-07 |
| Find all providers in MANSFIELD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.