Family Practice Center of Wadsworth Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

35050673F Issued in OH

Legal business name

FAMILY PRACTICE CENTER OF WADSWORTH INC

Practice address

251 Leatherman Rd
Wadsworth, OH 44281-9236

Phone

(330) 334-6229

Fax

(330) 334-6110

NPI assigned

Feb 22, 2007

Organization subpart

No

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

Authorized official

Name

Patricia Walker

Title

Practice Administrator

Phone

(330) 334-6229

Specialties & licenses 1

Addresses

Other identifiers 10

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475798400000",
    "number": "1093840993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 LEATHERMAN RD",
            "city": "WADSWORTH",
            "state": "OH",
            "postal_code": "442819236",
            "telephone_number": "330-334-6229",
            "fax_number": "330-334-6110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 LEATHERMAN RD",
            "city": "WADSWORTH",
            "state": "OH",
            "postal_code": "442819236",
            "telephone_number": "330-334-6229",
            "fax_number": "330-334-6110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY PRACTICE CENTER OF WADSWORTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2016-10-07",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "330-334-6229"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35050673F",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN-FPCW",
            "identifier": "9265331",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOSHUA D. RAINES, DO MEDICAID ID",
            "identifier": "0102518",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MATTHEW P. FINNERAN, MD MEDICARE UPIN",
            "identifier": "A16460",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3107668",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOSHUA D. RAINES, DO MEDICARE PTAN",
            "identifier": "H206900",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BRINKMAN A. MURRAY, DO MEDICARE PTAN",
            "identifier": "H437901",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0557848",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID FPCW",
            "identifier": "2164250",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3000344",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CYNTHIA MAZEY, CNP PTAN",
            "identifier": "H403930",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Family Connection 9 LLC
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• Family Connection of Wadsworth 3 LLC
• Family Connection of Wadsworth IV, LLC
• Family Dentistry on the Square, Inc
• Family Statcare of Northeast Ohio, LLC
• Theresa Ann Farello, LPCC
• Melissa Renne Farnsworth, LMT
• Joanna Farragher, CNP
• Miranda Fedor

• Family Medicine Physician in Wadsworth, OH
• Providers in Wadsworth, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.