Westshore Primary Care Assoc Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

WESTSHORE PRIMARY CARE ASSOC INC

Practice address

32730 Walker Road
Building H
Avon Lake, OH 44012

Phone

(440) 930-4955

Fax

(440) 930-4960

NPI assigned

Aug 24, 2006

Last updated

Jan 12, 2010By the provider in NPPES

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 3

Addresses

Other identifiers 1

Locations

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael A Adornetto, DO

  • Internal Medicine Physician
  • Westlake, OH
  • NPI 1235139767
  NPD (past)
• Vickie E Baker, M.D.

  • Family Medicine Physician
  • Cleveland, OH
  • NPI 1346205614
  NPD (past)
• Jennifer M Carandang, MD

  • Internal Medicine Physician
  • Avon, OH
  • NPI 1912909862
  NPD (past)
• Chantal I Dalencour, MD

  • Pediatrics Physician
  • North Ridgeville, OH
  • NPI 1265434120
  NPD (past)
• Laura A Davis Luarde, DO

  • Internal Medicine Physician
  • Avon, OH
  • NPI 1114919222
  NPD (past)
• Mark J Gipson, MD

  • Pediatrics Physician
  • Westlake, OH
  • NPI 1629070511
  NPD (past)
• Mona Jagetia, MD

  • Pediatrics Physician
  • N Ridgeville, OH
  • NPI 1346232188
  NPD (past)
• Matthew Kacir, MD

  • Pediatrics Physician
  • Avon, OH
  • NPI 1477555357
  NPD (past)
• Rayeka Sitabkhan, MD

  • Pediatrics Physician
  • Avon Lake, OH
  • NPI 1699767715
  NPD (past)
• Rajendran Sundaram, MD

  • Internal Medicine Physician
  • Lorain, OH
  • NPI 1396731865
  NPD (past)
• Peter A Valencic, MS RD LD

  • Registered Dietitian
  • Cleveland, OH
  • NPI 1346312394
  NPD (past)
• Thomas Wagner, DO

  • Family Medicine Physician
  • N Ridgeville, OH
  • NPI 1669464673
  NPD (past)

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263254400000",
    "number": "1295842284",
    "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": "32730 WALKER ROAD",
            "address_2": "BUILDING H",
            "city": "AVON LAKE",
            "state": "OH",
            "postal_code": "44012",
            "telephone_number": "440-930-4955",
            "fax_number": "440-930-4960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTSHORE PRIMARY CARE ASSOC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-24",
        "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": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0858077",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert C Warren, MD
• Jodi Washburn, PT
• Kathy Weaver
• Jodi Lee Weber, LCSW
• Western Reserve Counseling LLC
• Westshore Primary Care Assoc., Inc.
• Meghan Widmer
• Kenneth Willoughby Jr., PA-C
• Alison Wiswell
• Dominick Wobser

• Family Medicine Physician in Avon Lake, OH
• Providers in Avon Lake, OH by specialty
• Family 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.