NPIMap

Organization Active NPI

James P. Frackelton, MD, Inc

Doing business as Preventive Medicine Group

  • General Practice Physician
  • Westlake, OH
National Provider Identifier
1366642498
Registry record updated Jul 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
JAMES P. FRACKELTON, MD, INC
Doing business as
Preventive Medicine Group
Practice address
24700 Center Ridge Rd
Westlake, OH 44145-5636
Phone
(440) 835-0104
Fax
(440) 835-2177
NPI assigned
Jul 18, 2007
Last updated
Jul 18, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2007

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

Authorized official

Name
Susan Ann Wenger
Title
Manager
Phone
(440) 835-2150

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X NU Primary

Addresses

Primary practice location

24700 Center Ridge Rd
Westlake, OH 44145-5636

Mailing address

24700 Center Ridge Rd
Westlake, OH 44145-5636
Phone (440) 835-0104

Other names 1

  • Preventive Medicine Group Doing business as

National Provider Directory

National Provider Directory

Locations

24700 Center Ridge Rd
Ste 317
Westlake, OH 44145
Phone (440) 835-0104

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1184716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184716800000",
    "number": "1366642498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24700 CENTER RIDGE RD",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441455636",
            "telephone_number": "440-835-0104",
            "fax_number": "440-835-2177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24700 CENTER RIDGE RD",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441455636",
            "telephone_number": "440-835-0104",
            "fax_number": "440-835-2177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES P. FRACKELTON, MD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-18",
        "last_updated": "2007-07-18",
        "status": "A",
        "authorized_official_last_name": "WENGER",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "440-835-2150"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Preventive Medicine Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Westlake, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2007; 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.