Western Stark Medical Clinic, Inc

Primary specialty

Voluntary or Charitable AgencyTaxonomy code 251V00000X

License

194 Issued in OH

Legal business name

WESTERN STARK MEDICAL CLINIC, INC

Practice address

820 Amherst Rd NE
Massillon, OH 44646-8525

Phone

(330) 834-1546

Fax

(330) 834-1548

NPI assigned

Feb 12, 2007

Organization subpart

No

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

Authorized official

Name

Diane Daniels, MSS,MAC,LSW,EVCIII

Title

Ceo

Phone

(330) 834-1546

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1275674194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 AMHERST RD NE",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446468525",
            "telephone_number": "330-834-1546",
            "fax_number": "330-834-1548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 AMHERST RD NE",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446468525",
            "telephone_number": "330-834-1546",
            "fax_number": "330-834-1548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN STARK MEDICAL CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DANIELS",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "330-834-1546",
        "authorized_official_credential": "MSS,MAC,LSW,EVCIII"
    },
    "taxonomies": [
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": "OH",
            "license": "194",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2369726",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Todd David Werstler, O.D.
• West Medical,Inc.
• Gerald Lee West, PH.D.
• Westark Family Services, Inc.
• John C Westerbeck, MD
• Shaiann White
• Wendy Whitlock, LPN
• Christina Marie Whitt, CDCA
• Carrie Wiesen
• Raegan L Wigfield, RMA/STNA

• Voluntary or Charitable Agency in Massillon, OH
• Providers in Massillon, OH by specialty
• Voluntary or Charitable Agency in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.