Westshore Primary Care Assoc Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

WESTSHORE PRIMARY CARE ASSOC INC

Practice address

2535 Hale St
Suite a
Avon, OH 44011

Phone

(440) 934-8810

Fax

(440) 934-8811

NPI assigned

Aug 24, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Misty A Blaylock

Title

Credentialing Coordinator

Phone

(440) 892-6406

Specialties & licenses 3

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263254400000",
    "number": "1063529030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26908 DETROIT RD",
            "address_2": "SUITE 301",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441452398",
            "telephone_number": "440-617-1823",
            "fax_number": "440-617-0884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2535 HALE ST",
            "address_2": "SUITE A",
            "city": "AVON",
            "state": "OH",
            "postal_code": "44011",
            "telephone_number": "440-934-8810",
            "fax_number": "440-934-8811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTSHORE PRIMARY CARE ASSOC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-24",
        "last_updated": "2010-01-12",
        "status": "A",
        "authorized_official_last_name": "BLAYLOCK",
        "authorized_official_first_name": "MISTY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "440-892-6406"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0858077",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christina Marie Watkins, CNP
• John Thomas Webster, D.D.S
• Diane J Weisenberger, CRNA
• Wellstreet of Georgia PC
• Wendy S Hallier OD
• Westshore Primary Care Assoc., Inc.
• Westside Chiropractic and Wellness LLC
• Danyel Whitacre
• Wholistic Nutrition LLC
• Robin P Wiley, LDO

• Internal Medicine Physician in Avon, OH
• Providers in Avon, OH by specialty
• Internal Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.