ADVANCED DERMATOLOGY AND SKIN CANCER CENTER (NPI# 1710274014) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710274014 |
| Entity Type | Organization |
| Organization Name | ADVANCED DERMATOLOGY AND SKIN CANCER CENTER |
| Practice Address |
987 Boardman Canfield Rd Boardman OH 44512-4222 |
| Practice Telephone | 3309658760 |
| Practice Fax Number | 3309659325 |
| Mailing Telephone | 3309658760 |
| Mailing Fax Number | 3309659325 |
| Enumeration Date | 2011-07-07 |
| Last Update Date | 2011-10-20 |
| Authorized Official Name | MRS. VICKI GRONER (BILLING MANAGER) |
| Authorized Official Telephone | 3309658760 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | Laboratories |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497912893 | Advanced Dermatology and Skin Cancer Center | Clinical Medical Laboratory | 987 Boardman Canfield Rd, Boardman, OH 44512-4222 | 2008-05-22 |
| 1528147352 | Advanced Dermatology and Skin Cancer Center | Clinical Medical Laboratory | 987 Boardman Canfield Rd, Boardman, OH 44512-4222 | 2006-11-03 |
| 1831187764 | Advanced Dermatology and Skin Cancer Center | Specialist | 987 Boardman Canfield Rd, Boardman, OH 44512-4222 | 2005-10-13 |
| Street Address |
987 BOARDMAN CANFIELD RD |
| City | BOARDMAN |
| State | OH |
| Zip Code | 44512-4222 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215923115 | John Raymond Bernat | Specialist | 987 Boardman Canfield Rd, Boardman, OH 44512-4222 | 2005-09-26 |
| 1770092900 | Teresa Marie Shaffer | Nurse Practitioner | 987 Boardman Canfield Rd, Boardman, OH 44512-4222 | 2017-09-20 |
| 1659764108 | Laurie Anne Quattro | Physician Assistant | 987 Boardman Canfield Rd, Boardman, OH 44512-4222 | 2015-03-09 |
| 1093020133 | Mariel Bird | Dermatology | 987 Boardman Canfield Rd, Boardman, OH 44512-4222 | 2010-08-13 |
| 1497912893 | Advanced Dermatology and Skin Cancer Center | Clinical Medical Laboratory | 987 Boardman Canfield Rd, Boardman, OH 44512-4222 | 2008-05-22 |
| 1508062712 | Sarah J Kudelko | Physician Assistant | 987 Boardman Canfield Rd, Boardman, OH 44512-4222 | 2007-06-25 |
| 1528147352 | Advanced Dermatology and Skin Cancer Center | Clinical Medical Laboratory | 987 Boardman Canfield Rd, Boardman, OH 44512-4222 | 2006-11-03 |
| 1396733218 | Pamela Guerriere-kovach | Specialist | 987 Boardman Canfield Rd, Boardman, OH 44512-4222 | 2005-10-13 |
| 1831187764 | Advanced Dermatology and Skin Cancer Center | Specialist | 987 Boardman Canfield Rd, Boardman, OH 44512-4222 | 2005-10-13 |
| 1316933260 | Patrick L. Shannon | Specialist | 987 Boardman Canfield Rd, Boardman, OH 44512-4222 | 2005-09-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285248740 | Kimberly Vrabel | Counselor | 725 Boardman Canfield Road Road Unit 1 and Unit 2, Boardman, OH 44512 | 2020-09-02 |
| 1043830144 | Steffi Lorraine D'souza | Student in an Organized Health Care Education/Training Program | 8423 Market Street Suite 101 St. Elizabeth Boardman Hos, Boardman, OH 44512 | 2020-04-20 |
| 1427677830 | Shivani Sharma | Family Medicine | 8423 Market Street Suite 101, St Elizabeth Boardman Hospital, Boardman, OH 44512 | 2020-04-15 |
| 1417587825 | Ronny Zetts | Pharmacist | 308 Boardman-canfield Rd, Boardman, OH 44512 | 2020-01-24 |
| 1285105080 | Andrew Dawson | Nurse Practitioner | 883 Boardman Canfield Rd Ste 105, Youngstown, OH 44512 | 2018-12-06 |
| 1700374949 | Adam Leid | Student in an Organized Health Care Education/Training Program | St Elizabeth Boardman Hospital - Medical Education Dept, 8401 Market Street, Boardman, OH 44512 | 2018-04-24 |
| 1528574910 | Herman Frank IIi | Licensed Practical Nurse | 920 Boardman Canfield Road, Boardman, OH 44512 | 2017-12-20 |
| 1730601980 | Stephanie Ann Mathews | Nurse Practitioner | 7600 Southern Blvd #1, Boardman, OH 44512 | 2017-07-10 |
| 1417485079 | Telka Ghobadi | Family Medicine | 8423 Market St., Suite 101, Boardman, OH 44512 | 2017-05-26 |
| 1356797534 | Haroon Hussain Syed | Student in an Organized Health Care Education/Training Program | 8423 Market Street, St. Elizabeth Boardman Hospital, Boardman, OH 44512 | 2016-05-06 |
| Find all providers in zip 44512 | ||||
| Taxonomy Code | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962659656 | Quest Diagnostics of Pennsylvania Inc | Clinical Medical Laboratory | 835 Southwestern Run, Laboratory, Boardman, OH 44514-0000 | 2008-08-25 |
| 1497912893 | Advanced Dermatology and Skin Cancer Center | Clinical Medical Laboratory | 987 Boardman Canfield Rd, Boardman, OH 44512-4222 | 2008-05-22 |
| 1275608622 | Humility of Mary Health Partners | Clinical Medical Laboratory | 8401 Market St, Boardman, OH 44512-6777 | 2006-11-21 |
| 1528147352 | Advanced Dermatology and Skin Cancer Center | Clinical Medical Laboratory | 987 Boardman Canfield Rd, Boardman, OH 44512-4222 | 2006-11-03 |
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| 1699384412 | Cleveland Diagnostics, Inc. | Clinical Medical Laboratory | 3615 Superior Ave E Ste 4407b, Cleveland, OH 44114-4139 | 2020-07-28 |
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| 1053937219 | Quest Diagnostics LLC Il | Clinical Medical Laboratory | 23030 State Route 73 Ste A, West Portsmouth, OH 45663-8861 | 2020-06-23 |
| 1942832084 | M1 Labs, LLC | Clinical Medical Laboratory | 1330 State Route 14, Columbiana, OH 44408 | 2020-02-06 |
| 1679123970 | Compunet Clinical Laboratories LLC | Clinical Medical Laboratory | 300 Austin West Blvd, Miamisburg, OH 45342-7519 | 2019-09-18 |
| 1780240788 | Access Hospital Dayton Lab LLC | Clinical Medical Laboratory | 2611 Wayne Ave Bldg 63, Dayton, OH 45420-1833 | 2019-05-15 |
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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.