Westlake Primary Care Associates

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

WESTLAKE PRIMARY CARE ASSOCIATES

Practice address

21851 Center Ridge Rd
411
Rocky River, OH 44116-3976

Phone

(216) 437-0047

Fax

(206) 888-0360

NPI assigned

Sep 24, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Patrick J Fetters, N.D., MSP

Title

Doctor

Phone

(216) 437-0047

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1222214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222214400000",
    "number": "1427208628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1502 WEYMOUTH CIR",
            "address_2": "SUITE 309",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441456192",
            "telephone_number": "440-539-0219",
            "fax_number": "206-888-0360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21851 CENTER RIDGE RD",
            "address_2": "411",
            "city": "ROCKY RIVER",
            "state": "OH",
            "postal_code": "441163976",
            "telephone_number": "216-437-0047",
            "fax_number": "206-888-0360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTLAKE PRIMARY CARE ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-24",
        "last_updated": "2008-09-24",
        "status": "A",
        "authorized_official_last_name": "FETTERS",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "216-437-0047",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "N.D., MSP"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "OH",
            "license": null,
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "OH",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0001",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Rocky River, OH
• Providers in Rocky River, OH by specialty
• Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 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.