Kevin J Masterson MD Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

35-04-5048-M Issued in OH

Legal business name

KEVIN J MASTERSON MD INC

Practice address

20455 Lorain Rd
Suite 102
Fairview Park, OH 44126-3529

Phone

(440) 356-5477

Fax

(440) 356-5885

NPI assigned

Feb 8, 2012

Organization subpart

No

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

Authorized official

Name

Kevin J Masterson, MD

Title

President

Phone

(440) 356-5477

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kevin J Masterson MD Doing business as

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

{
    "created_epoch": "1328659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328659200000",
    "number": "1427320266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20455 LORAIN RD.",
            "address_2": "SUITE 102",
            "city": "FAIRVIEW PARK",
            "state": "OH",
            "postal_code": "441263529",
            "telephone_number": "440-356-5477",
            "fax_number": "440-356-5885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20455 LORAIN RD",
            "address_2": "SUITE 102",
            "city": "FAIRVIEW PARK",
            "state": "OH",
            "postal_code": "441263529",
            "telephone_number": "440-356-5477",
            "fax_number": "440-356-5885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEVIN J MASTERSON MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-08",
        "last_updated": "2012-02-08",
        "status": "A",
        "authorized_official_last_name": "MASTERSON",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "440-356-5477",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35-04-5048-M",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0481554",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kevin J Masterson MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Elizabeth Kaple, LSW
• Matthew J Katz, LMT
• Keith J. Alexander, D.D.S., Inc.
• Sarah Jane Kenney, LISW
• Edward J Kenny, CRNA
• Mauni Khoury, M. ED, CAGS
• Ahmad Kilani, MD
• Gary Alex Kizzen, D.D.S.
• Robert L Klaus, MD
• Paige Knapp, O.D.

• Family Medicine Physician in Fairview Park, OH
• Providers in Fairview Park, 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 Feb 8, 2012; 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.