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Partners Physician Group

Organization Active NPI Vascular Surgery Physician · Wooster, OH

NPI 1265700520 · NPPES record last updated Jun 22, 2015

Key facts

NPI
1265700520
Entity type
Organization (NPI type 2)
Primary specialty
Vascular Surgery Physician 2086S0129X
Legal business name
PARTNERS PHYSICIAN GROUP
Practice address
1761 Beall Ave
Wooster, OH 44691-2342
Phone
(330) 344-1400
Fax
(330) 344-0112
NPI assigned
Dec 1, 2011
Organization subpart
No

Authorized official

Name
Kenneth Braman, DO NPI 1649250374
Title
Chief Medical Officer
Phone
(330) 665-8302

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Corporate family (same tax ID) 44

Organizations that report the same tax identification number in the National Provider Directory.

View all 44

Practitioners 129

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

View all 129

National Provider Directory

Tax ID family
NGH Dba Kimberly a Whit (45 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 2086S0129X OH Yes
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 208G00000X OH

Addresses

Primary practice location

1761 Beall Ave
Wooster, OH 44691-2342

Mailing address

1761 Beall Ave
Wooster, OH 44691-2342
Phone (330) 344-1400

Other identifiers

IdentifierTypeStateIssuer
9338635OtherOHPARTNERS PHYSICIAN GROUP MEDICARE GROUP #
2551671OtherOHPARTNERS PHYSICIAN GROUP MEDICAID GROUP #
1841239274OtherOHPARTNERS PHYSICIAN GROUP TYPE 2 NPI #

Other names

  • Cardiac, Thoracic & Vascular Specialists Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 22, 2015.

{
    "created_epoch": "1322697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434931200000",
    "number": "1265700520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1761 BEALL AVE",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446912342",
            "telephone_number": "330-344-1400",
            "fax_number": "330-344-0112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1761 BEALL AVE",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446912342",
            "telephone_number": "330-344-1400",
            "fax_number": "330-344-0112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARTNERS PHYSICIAN GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-01",
        "last_updated": "2015-06-22",
        "status": "A",
        "authorized_official_last_name": "BRAMAN",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "330-665-8302",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "OH",
            "license": null,
            "primary": true
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "OH",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS PHYSICIAN GROUP MEDICARE GROUP #",
            "identifier": "9338635",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS PHYSICIAN GROUP MEDICAID GROUP #",
            "identifier": "2551671",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS PHYSICIAN GROUP TYPE 2 NPI #",
            "identifier": "1841239274",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cardiac, Thoracic & Vascular Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wooster, OH

All providers in Wooster, OH · Vascular Surgery Physician in Ohio

Sources for this page

Verify at the official NPI Registry.