CHRIST JOHN TICORAS (NPI# 1821099615) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821099615 |
| Entity Type | Individual |
| Full Name | CHRIST JOHN TICORAS |
| Credential | M.D. |
| Practice Address |
770 Balgreen Dr Ste 201 Mansfield OH 44906-4106 |
| Practice Telephone | 4197561600 |
| Practice Fax Number | 4197751196 |
| Mailing Telephone | 4197561600 |
| Mailing Fax Number | 4197751196 |
| Enumeration Date | 2005-08-03 |
| Last Update Date | 2010-06-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 35-06-3717T | OH | Allopathic & Osteopathic Physicians |
| N | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
35-06-3717T | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 2146574 | 05 | |
| OH | BCBS | 000000199905 | 01 |
| Street Address |
770 BALGREEN DR STE 201 |
| City | MANSFIELD |
| State | OH |
| Zip Code | 44906-4106 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124478425 | Jeffrey M. Walthour | Pharmacist | 770 Balgreen Dr, Suite 104, Mansfield, OH 44906-4106 | 2016-06-16 |
| 1396147831 | Kristyn Livorno | Audiologist | 770 Balgreen Dr, Ste. 209, Mansfield, OH 44906-4106 | 2014-09-16 |
| 1558609990 | Third Street Community Clinic, Inc | Obstetrics & Gynecology | 770 Balgreen Dr, Mansfield, OH 44906-4106 | 2013-01-18 |
| 1093085466 | William Scott Ballinger,m.d. | Internal Medicine | 770 Balgreen Dr, Suite 203, Mansfield, OH 44906-4106 | 2012-01-03 |
| 1316225618 | Ent Central LLC | Otolaryngology | 770 Balgreen Dr, Suite 209, Mansfield, OH 44906-4106 | 2011-08-03 |
| 1023306263 | Lab One of Ohio Inc | Clinical Medical Laboratory | 770 Balgreen Dr, Mansfield, OH 44906-4106 | 2011-07-20 |
| 1093984767 | Walter G. Bodjanac, Do, LLC | Plastic Surgery | 770 Balgreen Dr, Suite 109, Mansfield, OH 44906-4106 | 2008-02-26 |
| 1679766034 | Mykola O. Prykhodko | Otolaryngology | 770 Balgreen Dr, Suite 209, Mansfield, OH 44906-4106 | 2007-08-20 |
| 1003030883 | Midwestern Cardiac Surgery, Inc. | Specialist | 770 Balgreen Dr, Suite 107, Mansfield, OH 44906-4106 | 2007-04-12 |
| 1306958723 | Cornerstone Ob-gyn, Inc | Obstetrics & Gynecology | 770 Balgreen Dr, Suite 207, Mansfield, OH 44906-4106 | 2006-08-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154920155 | Jonathan Clevenger | Pharmacist | 1455 North Lexington-springmill Road, Ontario, OH 44906 | 2020-10-21 |
| 1366083297 | Jennifer Robin Young | Technician | 60 Sherman Ave, Mansfield, OH 44906 | 2019-10-02 |
| 1639721905 | Lora Harris | Nurse Practitioner | 1029 S. Trimble Rd, Mansfield, OH 44906 | 2019-07-16 |
| 1871098855 | Med Gear Plus, LLC | Durable Medical Equipment & Medical Supplies | 1041 Park Ave W, Mansfield, OH 44906 | 2018-03-29 |
| 1912401209 | Bradley Anderson | Dietitian, Registered | 1025 South Trimble Rd., Mansfield, OH 44906 | 2018-03-21 |
| 1104325182 | Nancy Labaki | Speech-Language Pathologist | 2011 W. Fourth St., Mansfield, OH 44906 | 2018-02-06 |
| 1720518319 | Stephen Anderson | Counselor | 680 Park Ave W., Mansfield, OH 44906 | 2017-06-15 |
| 1427422518 | Jill A Waite | Counselor | 33 S. Lexington-springmill Road, Mansfield, OH 44906 | 2015-11-30 |
| 1992125397 | Taryn Boyd | Physical Therapist | 1025 S Trimble, Mansfield, OH 44906 | 2014-04-24 |
| 1356760870 | Sarah Brandyberry | Social Worker | 1025 S. Trimble Rd., Mansfield, OH 44906 | 2014-04-11 |
| Find all providers in zip 44906 | ||||
| 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 |
|---|---|---|---|---|
| 1437672334 | Virt Derm, Pllc | Dermatology | 4516 Lakota Trl, Mansfield, TX 76063-2312 | 2017-07-23 |
| 1518063056 | Deborah Lynne Moritz | Dermatology | 161 Cline Avenue, Mansfield, OH 44907 | 2006-09-15 |
| 1205814712 | Timothy Clifton Wood | Dermatology | 480 Glessner Ave, Mansfield, OH 44903-2056 | 2006-01-04 |
| 1902160708 | Helen Kaporis | Dermatology | 2800 E Broad St, Ste 124, Mansfield, TX 76063-6409 | 2012-06-27 |
| 1598913253 | Mansfield Dermatology, Pllc | Dermatology | 2800 E Broad St, Suite 408, Mansfield, TX 76063-6414 | 2008-09-05 |
| 1669661138 | Dermatology Associates of Mansfield, Inc | Dermatology | 480 Glessner Ave, Mansfield, OH 44903-2056 | 2007-10-19 |
| 1316030521 | Mansfield Dermatology Inc | Dermatology | 161 Cline Avenue, Mansfield, OH 44907 | 2006-10-02 |
| 1578513933 | Jeannine Koay Hoang | Dermatology | 2800 E Broad St, Suite 124, Mansfield, TX 76063 | 2006-05-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023623808 | Bria Deshea Barjuca | Dermatology | 4450 Eastgate Blvd Ste 232, Cincinnati, OH 45245-1788 | 2020-09-09 |
| 1184263675 | Sunkiss Essentials LLC | Dermatology | 2926 State Rd Ste 369, Cuyahoga Falls, OH 44223-1244 | 2019-12-31 |
| 1770048894 | Teresa O'connell | Dermatology | Timeless Skin Solutions, 31 South High St, Dublin, OH 43017 | 2019-02-02 |
| 1144737560 | Robert Brody Md Co | Dermatology | 3461 Warrensville Center Rd Ste 101, Shaker Heights, OH 44122-5227 | 2018-01-08 |
| 1366893752 | Kirsten Dickinson | Dermatology | Cleveland Clinic 9500 Euclin Ave, Cleveland, OH 44195-1009 | 2016-06-27 |
| 1649629692 | Megan Ashley Jones-sheets | Dermatology | 75 Metro Place North, Suite 195, Dublin, OH 43017 | 2016-06-10 |
| 1275982746 | Samantha N Barry | Dermatology | 9403 Kenwood Rd Ste B100, Blue Ash, OH 45242-6858 | 2016-06-06 |
| 1720433592 | Nitin Tiwari | Dermatology | 4439 State Route 159 Ste G50, Chillicothe, OH 45601-7202 | 2016-04-29 |
| 1487008751 | Kiyanna Marie Williams | Dermatology | 2049 E 100th St A Building, Cleveland, OH 44195-1014 | 2016-04-22 |
| 1336502038 | Jacqueline Graham | Dermatology | 566 White Pond Dr Ste E, Akron, OH 44320-1116 | 2016-03-30 |
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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.