NPIMap

Individual provider Active NPI

Paul David Wesson II, DO

  • Family Medicine Physician
  • Kenton, OH
National Provider Identifier
1659362176
Registry record updated Jan 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34006208 Issued in OH
Practice address
75 Washington Blvd
#101
Kenton, OH 43326-4001
Phone
(419) 675-1962
Fax
(419) 673-8058
NPI assigned
Nov 3, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 34006208 OH Primary

Addresses

Primary practice location

75 Washington Blvd
#101
Kenton, OH 43326-4001

Mailing address

PO Box 418
Kenton, OH 43326-0418
Phone (419) 675-1962

Other identifiers 1

IdentifierTypeStateIssuer
0174289MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pwesson411843@direct.ohiohealth.com OhioHealth Physician Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040319000349 OH Practitioner - Family Practice 2961392238 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
College of Physicians and Surgeons (Kansas), 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

75 Washington Blvd
Suite 101
Kenton, OH 43326-4001
Phone (419) 675-1962

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
34006208OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kenton Family Practice LLC Family Medicine CurrentSince Oct 1, 2003 Accepting new patients
Nes Ohio Inc Past Accepting new patients
Nes Ohio, Inc. Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

75 Washington Blvd
Ste 104
Kenton, OH 43326
Phone (419) 673-5257

75 Washington Blvd
Ste 101
Kenton, OH 43326
Phone (419) 673-0833

921 E Franklin St
Kenton, OH 43326
Phone (419) 673-0761

75 Washington Blvd
Ste 102
Kenton, OH 43326
Phone (419) 674-7110

Organizations & group practices 4

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643068800000",
    "number": "1659362176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 418",
            "city": "KENTON",
            "state": "OH",
            "postal_code": "433260418",
            "telephone_number": "419-675-1962",
            "fax_number": "419-673-8058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 WASHINGTON BLVD",
            "address_2": "#101",
            "city": "KENTON",
            "state": "OH",
            "postal_code": "433264001",
            "telephone_number": "419-675-1962",
            "fax_number": "419-673-8058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESSON",
        "first_name": "PAUL",
        "middle_name": "DAVID",
        "name_suffix": "II",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-03",
        "last_updated": "2022-01-25",
        "certification_date": "2021-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34006208",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0174289",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pwesson411843@direct.ohiohealth.com",
            "affiliation": "Y",
            "affiliationName": "OhioHealth Physician Group",
            "address_1": "216 E Lima St",
            "city": "Forest",
            "state": "OH",
            "country_code": "US",
            "postal_code": "458431118",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kenton, OH

Sources for this page

Verify at the official NPI Registry.