SUSAN C MASSICK (NPI# 1144202490) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144202490 |
| Entity Type | Individual |
| Full Name | SUSAN C MASSICK |
| Credential | MD |
| Practice Address |
5175 Morse Rd Suite 100 Gahanna OH 43230-1370 |
| Mailing Address |
700 Ackerman Rd Suite 385 Columbus OH 43202-1559 |
| Practice Telephone | 6142931707 |
| Practice Fax Number | 6142931716 |
| Mailing Telephone | 6149473700 |
| Mailing Fax Number | 6149473771 |
| Enumeration Date | 2005-11-14 |
| Last Update Date | 2011-03-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 35078051 | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 2794669 | 05 |
| Street Address |
5175 MORSE RD SUITE 100 |
| City | GAHANNA |
| State | OH |
| Zip Code | 43230-1370 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427357284 | Elizabeth A Little | Pediatrics | 5175 Morse Rd, Suite 400, Gahanna, OH 43230-1370 | 2011-03-19 |
| 1881925527 | Advanced Dental Care Center | Dentist | 5175 Morse Rd, Suite 200, Gahanna, OH 43230-1370 | 2010-01-20 |
| 1194942532 | Carolyn T Mickelson | Audiologist | 5175 Morse Rd, Gahanna, OH 43230-1370 | 2007-04-19 |
| 1427119866 | Minka Latrice Schofield | Otolaryngology | 5175 Morse Rd, Gahanna, OH 43230-1370 | 2006-12-12 |
| 1023087483 | Sean Michael Vellucci | Pediatrics | 5175 Morse Rd, Suite 400, Gahanna, OH 43230-1370 | 2006-03-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013518695 | Adonna Fuller | Technician | 14o Imperial Drive, Apt 120, Gahanna, OH 43230 | 2020-11-02 |
| 1407471733 | Brent Flory | Counselor | 425 South Hamilton, Gahanna, OH 43230 | 2020-06-12 |
| 1245865252 | Amy Marie Cosma | Registered Nurse | 750 Cross Pointe Road, Suite D, Gahanna, OH 43230 | 2020-03-10 |
| 1447718010 | Yolanda Renee Davis | Case Manager/Care Coordinator | 1490 E Main St., Columbus, OH 43230 | 2019-03-03 |
| 1699261537 | Cap City Supported Living & Homecare Services, LLC | Home Health | 2305 South Hamilton Road, Suite 216, Columbus, OH 43230 | 2018-07-03 |
| 1467957183 | Kendra Marie Peterson | Specialist/Technologist | 1011 Arcaro Drive, Gahanna, OH 43230 | 2018-03-26 |
| 1467956805 | Beatrice Njeri Gachoro | Registered Nurse | 4484 Shady Blossom Ln, Columbus, OH 43230 | 2018-03-21 |
| 1760900211 | Centra Home Health Care, LLC | Home Health | 4745 Legare Ln, Columbus, OH 43230 | 2017-09-05 |
| 1386164325 | Ziad Al Hennawi | Dentist | 4034 Morse Rd, Columbus, OH 43230 | 2017-06-21 |
| 1336675503 | Fresenius Medical Care New Albany, LLC | Clinic/Center | 991 E Johnstown Rd, Gahanna, OH 43230 | 2017-05-10 |
| Find all providers in zip 43230 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659381754 | Mark Bechtel | Dermatology | 540 Officenter Pl Ste 240, Gahanna, OH 43230-5317 | 2006-08-09 |
| 1144230905 | Larisa Ravitskiy | Dermatology | 602 Morrison Rd, Gahanna, OH 43230 | 2006-08-08 |
| 1609882836 | Northeast Dermatology and Cosmetic Surgery Center | Dermatology | 925 North Hamilton Road, Suite 100, Gahanna, OH 43230-4566 | 2006-07-31 |
| 1922093459 | Stephanie L Cotell | Dermatology | 925 N Hamilton Rd Ste 100, Gahanna, OH 43230-8709 | 2005-09-12 |
| 1154323681 | Joel Bain Herron | Dermatology | 925 N Hamilton Rd, Suite 100, Gahanna, OH 43230-8708 | 2005-08-15 |
| 1568882116 | Peter John Hayes | Dermatology | 725 Buckles Court North, Suite 120, Gahanna, OH 43220 | 2014-04-22 |
| 1386063642 | Catherine Ann Ulman | Dermatology | 540 Officenter Pl, Gahanna, OH 43230-5317 | 2014-04-15 |
| 1457785610 | John Christopher Lorenzo Trinidad | Dermatology | 540 Officenter Pl, 240, Gahanna, OH 43230-5317 | 2013-08-23 |
| 1700128584 | Desmond M Shipp | Dermatology | 540 Officenter Pl, Gahanna, OH 43230-5317 | 2013-03-20 |
| 1164798500 | Stephanie K. Fabbro | Dermatology | 540 Officenter Pl, Gahanna, OH 43230-5317 | 2012-03-29 |
| Find all providers in GAHANNA | ||||
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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.