North Shore Gastroenterology, Inc

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

Legal business name

NORTH SHORE GASTROENTEROLOGY, INC

Practice address

850 Columbia Rd
Suite 200
Westlake, OH 44145-1493

Phone

(440) 808-1212

Fax

(440) 808-0321

NPI assigned

Feb 12, 2015

Last updated

Apr 12, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Janene Weills

Title

Credentialing & Contracting Coord

Phone

(440) 808-1212

Specialties & licenses 2

Addresses

Other identifiers 1

Practitioners 1

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.

• Kimberly Conley, AANP NP-C

  • Family Nurse Practitioner
  • Westlake, OH
  • NPI 1346605102
  NPD

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

{
    "created_epoch": "1423699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523491200000",
    "number": "1639560675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 COLUMBIA RD STE 200",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441457215",
            "telephone_number": "440-808-1212",
            "fax_number": "440-808-0321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 COLUMBIA RD",
            "address_2": "SUITE 200",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441451493",
            "telephone_number": "440-808-1212",
            "fax_number": "440-808-0321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SHORE GASTROENTEROLOGY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-12",
        "last_updated": "2018-04-12",
        "status": "A",
        "authorized_official_last_name": "WEILLS",
        "authorized_official_first_name": "JANENE",
        "authorized_official_title_or_position": "CREDENTIALING & CONTRACTING COORD",
        "authorized_official_telephone_number": "440-808-1212"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO LICENSE",
            "identifier": "COA16300-NP",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• North Ohio Gastroenterology
• North Ohio Heart Center, Inc
• North Ohio Medical Imaging
• North Shore Anesthesia Limited, LLC
• North Shore Endoscopy Center
• North Shore Gastroenterology, Inc.
• North Shore Pathology LLC
• Northcoast Anesthesia Providers
• Northcoast Anesthesia Providers
• Northcoast Hand Center Inc.

• Adult Health Nurse Practitioner in Westlake, OH
• Providers in Westlake, OH by specialty
• Adult Health Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2018; 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.