Westshore Primary Care Assoc., Inc.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

WESTSHORE PRIMARY CARE ASSOC., INC.

Practice address

28575 Westlake Village Dr
Westlake, OH 44145-3883

Phone

(440) 892-4200

NPI assigned

Feb 19, 2008

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 1

Addresses

Other identifiers 1

Locations

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Vickie E Baker, M.D.

  • Family Medicine Physician
  • Cleveland, OH
  • NPI 1346205614
  NPD (past)
• Abby L Harting, CNP

  • Family Nurse Practitioner
  • North Olmsted, OH
  • NPI 1952885295
  NPD (past)
• Lauren Elizabeth Kerr, M.D.

  • Obstetrics & Gynecology Physician
  • Westlake, OH
  • NPI 1861621344
  NPD (past)
• Mary R Klein, MD

  • Family Medicine Physician
  • Cleveland, OH
  • NPI 1306848114
  NPD (past)
• Roger A Mansnerus, MD

  • Internal Medicine Physician
  • Westlake, OH
  • NPI 1659373538
  NPD (past)
• Michele Moore, D.O.

  • Family Medicine Physician
  • Brooklyn, OH
  • NPI 1255433371
  NPD (past)
• Michelle R Riley, DO

  • Internal Medicine Physician
  • Avon, OH
  • NPI 1952370090
  NPD (past)
• Sue T Suglio, RD, LD, CDE

  • Registered Dietitian
  • Westlake, OH
  • NPI 1558363457
  NPD (past)
• Rajendran Sundaram, MD

  • Internal Medicine Physician
  • Lorain, OH
  • NPI 1396731865
  NPD (past)
• Agnes Thomas, MD

  • Family Medicine Physician
  • Westlake, OH
  • NPI 1700878485
  NPD (past)
• Robin A Thomas, D.O.

  • Internal Medicine Physician
  • Richmond HTS, OH
  • NPI 1912955808
  NPD (past)
• John J Wolf III, DO

  • Family Medicine Physician
  • Westlake, OH
  • NPI 1689666737
  NPD (past)

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

{
    "created_epoch": "1203379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263254400000",
    "number": "1154599504",
    "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": "28575 WESTLAKE VILLAGE DR",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441453883",
            "telephone_number": "440-892-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTSHORE PRIMARY CARE ASSOC., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-19",
        "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": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0858077",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Westshore Dermatology Inc
• Westshore Primary Care Assoc Inc
• Westshore Primary Care Assoc Inc
• Westshore Primary Care Assoc. Inc.
• Westshore Primary Care Assoc., Inc.
• Westshore Primary Care Assoc., Inc.
• Westshore Primary Care Assoc., Inc.
• Westside Behavioral Health, LLC
• Westside Hematology Oncology Inc
• Westside Medicine & Cardiology Inc

• Internal Medicine Physician in Westlake, OH
• Providers in Westlake, 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.