Active NPI
Maureen Gwynn, PA-C
- Physician Assistant
- Independence, OH
National Provider Identifier
1255374922
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 50000802
- Practice address
- 6000 W Creek Rd
Suite 10
Independence, OH 44131-2139 - Phone
- (800) 223-2273
- NPI assigned
- Jun 13, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 50000802 | OH | Primary |
Addresses
Primary practice location
6000 W Creek Rd
Suite 10
Independence, OH 44131-2139
Mailing address
49300 State RT 20
Oberlin, OH 44074
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 50000802 | OH | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emergency Professionals of Ohio, Inc. | Physician Assistant | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Nurse Practitioner
- Athens, OH
- NPI 1750313854
Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214956800000",
"number": "1255374922",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "49300 STATE RT 20",
"city": "OBERLIN",
"state": "OH",
"postal_code": "44074"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6000 W CREEK RD",
"address_2": "SUITE 10",
"city": "INDEPENDENCE",
"state": "OH",
"postal_code": "441312139",
"telephone_number": "800-223-2273"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GWYNN",
"first_name": "MAUREEN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-13",
"last_updated": "2008-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OH",
"license": "50000802",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Independence, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.