Marymount Primary Care Services, Inc

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Legal business name

MARYMOUNT PRIMARY CARE SERVICES, INC

Practice address

34501 Aurora Rd
Suite 101
Solon, OH 44139-3873

Phone

(440) 914-0960

NPI assigned

Aug 9, 2007

Last updated

May 27, 2008By 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

Peter P Walchanowicz

Title

Practice Manager

Phone

(440) 543-8855

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1186617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211846400000",
    "number": "1326230764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34501 AURORA RD",
            "address_2": "SUITE 101",
            "city": "SOLON",
            "state": "OH",
            "postal_code": "441393873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34501 AURORA RD",
            "address_2": "SUITE 101",
            "city": "SOLON",
            "state": "OH",
            "postal_code": "441393873",
            "telephone_number": "440-914-0960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYMOUNT PRIMARY CARE SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-09",
        "last_updated": "2008-05-27",
        "status": "A",
        "authorized_official_last_name": "WALCHANOWICZ",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "440-543-8855"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2088940",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000564024",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Avgero Manouselis
• Marc Glassman Inc (Marcs)
• Robyn Hellman Margolis, MBA,PT
• Beth Anne Martin, PHD
• Richard A. Marvin, L.S.W.
• Joan Maser, LISW
• Julia A Mason, STNA
• Sharon D Mason, QMHS
• Paula Jean Matney, OTA1155
• Ashley Elizabeth Matousek

• Obstetrics & Gynecology Physician in Solon, OH
• Providers in Solon, OH by specialty
• Obstetrics & Gynecology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 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.

Verify at the official NPI Registry.