Nicole Wadsworth, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

34.007038 Issued in OH

Practice address

7123 Pearl Rd
Middleburg Heights, OH 44130-4975

Phone

(440) 842-7990

Fax

(440) 842-8835

NPI assigned

Jul 25, 2006

Last updated

Aug 15, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Southwest General Brunswick Emergency Center

  • Personal Emergency Response Attendant
  • Brunswick, OH
  • NPI 1316272412
  NPD (past)

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471219200000",
    "number": "1487677290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 WARWICK LN",
            "city": "ATHENS",
            "state": "OH",
            "postal_code": "457013368",
            "telephone_number": "740-707-4598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7123 PEARL RD",
            "city": "MIDDLEBURG HEIGHTS",
            "state": "OH",
            "postal_code": "441304975",
            "telephone_number": "440-842-7990",
            "fax_number": "440-842-8835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADSWORTH",
        "first_name": "NICOLE",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2016-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "34.007038",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE",
            "identifier": "942460636917",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR-GA",
            "identifier": "P00285501",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2184523",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vpa PC (HarmonyCares Medical Group)
• Vpa PC
• Madelyn Vrtacnik
• Chinmay B Vyas, MD
• Shannon Marie Wade, FNP
• James L Wagner, M.D.
• Walgreen Co (Walgreens #5031)
• Brett Walker, DMD
• Madison Leah Walker, BT
• Danielle Wall

• Emergency Medicine Physician in Middleburg Heights, OH
• Providers in Middleburg Heights, OH by specialty
• Emergency Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2016; 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.