CANTON UROLOGY ASSOCIATION, INC NPI 1588682892

Specialist in Canton, OH

NPI 1588682892 Organization Specialist CLIA Number 36D0700989 CLIA Certificate for Provider-Performed Microscopy Procedures (PPMP)

About CANTON UROLOGY ASSOCIATION, INC

Canton Urology Association,inc is a provider established in Canton, Ohio specializing in specialist. The NPI number of Canton Urology Association,inc is 1588682892 and was assigned on July 2006. The practitioner's primary taxonomy code is 174400000X with license number ========= (OH). The provider is registered as an organization and their NPI record was last updated one year ago. Canton Urology Association,inc operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Dr. George Wesley Kmetz Md (President)

The CLIA number of Canton Urology Association,inc is 36D0700989 registered as a "physician office" facility with a CLIA Certificate for Provider-Performed Microscopy Procedures (PPMP). This CLIA certificate is issued to Canton Urology Association,inc in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.

NPI

1588682892

Provider NameCANTON UROLOGY ASSOCIATION,INC
Provider Location Address2600 TUSCARAWAS ST W STE 400 CANTON, OH 44708
Provider Mailing Address2600 W TUSCARAWAS SUITE 400 CANTON, OH 44708
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date07-17-2006
Last Update Date08-22-2020


Primary Taxonomy

Taxonomy Code174400000X
ClassificationSpecialist
TypeOther Service Providers
License No.=========
License StateOH
Taxonomy DescriptionAn individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Business Address

CANTON UROLOGY ASSOCIATION,INC
2600 TUSCARAWAS ST W STE 400
CANTON, OH
ZIP 44708
Phone: (330) 458-2000
Fax: (330) 458-2010

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Mailing Address

CANTON UROLOGY ASSOCIATION,INC
2600 W TUSCARAWAS
SUITE 400
CANTON, OH
ZIP 44708
Phone: (330) 458-2000
Fax: (330) 458-2010



Authorized Official

Authorized Official NameDR. GEORGE WESLEY KMETZ MD
Authorized Official TitlePRESIDENT
Authorized Official Phone(330) 458-2000

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1588682892 is:

CLIA Number36D0700989
Facility TypePHYSICIAN OFFICE
Certificate TypeCertificate for Provider-Performed Microscopy Procedures (PPMP)

Group Taxonomy


193400000X SINGLE SPECIALTY GROUP - This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
0223350MEDICAID (05)OH

Other Providers at the same location


The following 5 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1598993149DR. CHRISTOPHER JOHN LOHR M.D.
Individual
Urology2600 TUSCARAWAS ST W STE 400
CANTON, OH 44708
(330) 458-2000
1063995264MRS. KATHERINE ANNA NIXON CNP
Individual
Urology2600 TUSCARAWAS ST W STE 400
CANTON, OH 44708
(330) 458-2000
1972135911 CHELSEA RUHL FNP
Individual
Nurse Practitioner (Family)2600 TUSCARAWAS ST W STE 400
CANTON, OH 44708
(330) 458-2000
1013159433 MATTHEW JOSEPH MAURICE M.D.
Individual
Urology2600 TUSCARAWAS ST W STE 400
CANTON, OH 44708
(330) 458-2000
1750912978MR. BENJAMIN CHRISTIAN LEHMAN CNP
Individual
Nurse Practitioner (Family)2600 TUSCARAWAS ST W STE 400
CANTON, OH 44708
(330) 458-2000

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.