Individual provider Active NPI

Heather A Westbrock, PA

  • Physician Assistant
  • Dayton, OH
National Provider Identifier
1639422496
Registry record updated Jan 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.003627 Issued in OH
Practice address
4100 W 3Rd St
Dayton, OH 45428-9000
Phone
(937) 268-6511
NPI assigned
Oct 18, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.003627 OH Primary

Addresses

Primary practice location

4100 W 3Rd St
Dayton, OH 45428-9000

Mailing address

4100 W 3Rd St
Dayton, OH 45428-9000
Phone (937) 268-6511

Other practice location 1

1 Medical Center Dr
Middletown, OH 45005-2584
Phone (513) 420-5017

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
50.003627OHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Middletown Emergency Physicians, Inc. Past Accepting new patients
Fairfield Hospitalists Inc Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1350518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546387200000",
    "number": "1639422496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 W 3RD ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454289000",
            "telephone_number": "937-268-6511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 W 3RD ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454289000",
            "telephone_number": "937-268-6511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Middletown",
            "state": "OH",
            "postal_code": "450052584",
            "country_code": "US",
            "telephone_number": "513-420-5017",
            "fax_number": "937-619-4150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WESTBROCK",
        "first_name": "HEATHER",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-18",
        "last_updated": "2019-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.003627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2019; 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.