Southwest General Medical Group, Inc.
Organization Active NPI Family Medicine Physician · Strongsville, OH
NPI 1104975895 · NPPES record last updated Feb 28, 2019
Key facts
- NPI
- 1104975895
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- SOUTHWEST GENERAL MEDICAL GROUP, INC.
- Practice address
- 18181 Pearl Rd
B202
Strongsville, OH 44136-6949 - Phone
- (440) 816-4965
- NPI assigned
- Jan 10, 2007
- Organization subpart
- No
Authorized official
- Name
- Heather Wagner
- Title
- Executive Director
- Phone
- (440) 816-4906
Other NPIs on the same Medicare enrollment 9
Practitioners 36
-
Muhammad Awais Aftab, M.B.B.S.
-
Cynthia L Aron, RD
-
Amy A Baldwin, ACNPC-AG
-
Sarpreet Bindra, MD
-
Debra M Calabrese, PA-C
-
Staci Cortelezzi, MS, RDN, LD
-
Kyle M Damron, D.O.
-
Jonathan A Dubsky, M.D.
-
Craig M Eyman, DO
-
Emily Havens, CRNA
-
Alison R Henton, CNP
-
Stephanie Kemp, LISW
-
Shahzad M Khan, M.D.
-
Kristine Kinsey, CNP
-
Cortney A Kohberger, M.D.
-
Julianne Lebo, PA
-
Larry G Lika, DO
-
Rafik Massouh, MD
-
Christine Miceli, PA-C
-
Samuel P Miranda, M.D.
-
Aparna Reddy, M.D.
-
David M Sfeir, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031210000789 | OH | Part B Supplier - Clinic/Group Practice | 8527964550 |
Receives reassigned benefits from 307 practitioners 9 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Middleburg Heights, OH; Middleburg HTS, OH; North Olmsted, OH; North Royalton, OH; Olmsted TWP, OH; Parma, OH; Strongsville, OH; Westlake, OH… |
National Provider Directory
Locations
18780 Bagley Rd
Ste 108
Middleburg Heights, OH 44130
Phone (440) 816-2330
18780 Bagley Rd
Ste 100
Middleburg Heights, OH 44130
Phone (440) 816-2850
18780 Bagley Rd
Ste 200
Middleburg Heights, OH 44130
Phone (440) 816-4546
7171 Royalton Rd
#201
North Royalton, OH 44133
Phone (440) 816-2878
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
18181 Pearl Rd
B202
Strongsville, OH 44136-6949
Mailing address
PO Box 638269
Cincinnati, OH 45263-0001
Phone (440) 816-4965
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CG4860 | Other | OH | RAILROAD MEDICARE |
| 2238199 | Medicaid | OH | |
| 2238144 | Medicaid | OH |
Other providers in Strongsville, OH
- Shantez Smith
- Tyler Snyder
- Solvaya Virtual Care LLC
- Sylvie Sonneman
- Southwest General Health Center
- Southwest General Medical Group, Inc.
- Southwest General Medical Group, Inc.
- Danielle Spangler
- Danielle Spatholt
- Spectera
All providers in Strongsville, OH · Family Medicine Physician in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 28, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.