Organization Active NPI

University Primary Care Practices Inc

Doing business as Western Reserve Physicians

  • Family Medicine Physician
  • Hudson, OH
National Provider Identifier
1740481357
Registry record updated Apr 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
UNIVERSITY PRIMARY CARE PRACTICES INC
Doing business as
Western Reserve Physicians
Practice address
5778 Darrow Rd Ste D
Hudson, OH 44236-3808
Phone
(330) 655-2161
Fax
(330) 650-2116
NPI assigned
May 30, 2007
Last updated
Apr 9, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2010

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

Authorized official

Name
Mr. Steve Riddle
Title
Director of Billing Services
Phone
(216) 383-6480

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OH Primary
Internal Medicine Physician 207R00000X OH

Addresses

Primary practice location

5778 Darrow Rd Ste D
Hudson, OH 44236-3808

Mailing address

PO Box 8792
Belfast, ME 04915-8792
Phone (330) 655-2161

Other names 1

  • WESTERN RESERVE PHYSICIANS Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031125000767 OH Part B Supplier - Clinic/Group Practice 3072417534 Receives reassigned benefits from 1,508 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270771200000",
    "number": "1740481357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8792",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049158792",
            "telephone_number": "330-655-2161",
            "fax_number": "330-650-2116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5778 DARROW RD STE D",
            "city": "HUDSON",
            "state": "OH",
            "postal_code": "442363808",
            "telephone_number": "330-655-2161",
            "fax_number": "330-650-2116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY PRIMARY CARE PRACTICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-30",
        "last_updated": "2010-04-09",
        "status": "A",
        "authorized_official_last_name": "RIDDLE",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "DIRECTOR OF BILLING SERVICES",
        "authorized_official_telephone_number": "216-383-6480",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WESTERN RESERVE PHYSICIANS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hudson, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.