Westshore Primary Care Assoc. Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

WESTSHORE PRIMARY CARE ASSOC. INC.

Practice address

26908 Detroit Rd
Suite 201
Westlake, OH 44145-2398

Phone

(440) 777-3500

Fax

(440) 716-2362

NPI assigned

Aug 7, 2006

Last updated

Aug 6, 2010By 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

Misty A Blaylock

Title

Credentialing Coordinator

Phone

(440) 892-6406

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281052800000",
    "number": "1649289695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26908 DETROIT RD",
            "address_2": "SUITE 301",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441452398",
            "telephone_number": "440-617-1823",
            "fax_number": "440-617-0884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26908 DETROIT RD",
            "address_2": "SUITE 201",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441452398",
            "telephone_number": "440-777-3500",
            "fax_number": "440-716-2362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTSHORE PRIMARY CARE ASSOC. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-07",
        "last_updated": "2010-08-06",
        "status": "A",
        "authorized_official_last_name": "BLAYLOCK",
        "authorized_official_first_name": "MISTY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "440-892-6406"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0858077",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Westlake R&N Opco, LLC
• Westshore Allergy and Immunology,LLC
• Westshore Dermatology Inc
• Westshore Primary Care Assoc Inc
• Westshore Primary Care Assoc Inc
• Westshore Primary Care Assoc., Inc.
• Westshore Primary Care Assoc., Inc.
• Westshore Primary Care Assoc., Inc.
• Westshore Primary Care Assoc., Inc.
• Westside Behavioral Health, LLC (Erin Cooper, PhD)

• Family Medicine Physician in Westlake, OH
• Providers in Westlake, 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 Aug 6, 2010; 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.