Westshore Primary Care Assoc Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

WESTSHORE PRIMARY CARE ASSOC INC

Practice address

34960 Center Ridge Rd
North Ridgeville, OH 44039

Phone

(440) 353-3433

Fax

(440) 353-3431

NPI assigned

Aug 24, 2006

Last updated

Jan 12, 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 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263254400000",
    "number": "1689781650",
    "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": "34960 CENTER RIDGE RD",
            "city": "NORTH RIDGEVILLE",
            "state": "OH",
            "postal_code": "44039",
            "telephone_number": "440-353-3433",
            "fax_number": "440-353-3431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTSHORE PRIMARY CARE ASSOC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-24",
        "last_updated": "2010-01-12",
        "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
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0858077",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shantelle Ward
• Kelsey Deann Watson, LISW
• Renee Wayne, FNP-BC
• Charles Arthur Weber, M.D.
• Alexandra Weiskittel, LPCC
• Elizabeth Anne White, SLP, SP
• Sheretta M White
• Jaimey Lynn Whitehead
• Lauren Williams, M.A. CCC-SLP
• Marquezia Williams, BCBA

• Family Medicine Physician in North Ridgeville, OH
• Providers in North Ridgeville, 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 Jan 12, 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.