Woodside Medical Group, Inc.

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

WOODSIDE MEDICAL GROUP, INC.

Practice address

475 Lexington Ave
Mansfield, OH 44907-1501

Phone

(419) 756-2003

Fax

(419) 756-3637

NPI assigned

Jan 12, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Robert Edwin Exten Jr., MD

Title

Pres

Phone

(419) 756-2003

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317686400000",
    "number": "1821148404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 LEXINGTON AVE",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449071501",
            "telephone_number": "419-756-2003",
            "fax_number": "419-756-3637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 LEXINGTON AVE",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449071501",
            "telephone_number": "419-756-2003",
            "fax_number": "419-756-3637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODSIDE MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-12",
        "last_updated": "2011-10-04",
        "status": "A",
        "authorized_official_last_name": "EXTEN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "EDWIN",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "419-756-2003",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy Clifton Wood, MD
• Jennifer Woodford, PA
• Sara Ann Woodruff
• Eric Woods, PA-S
• Rico Woods
• Kelly Marie Woodworth, PC-CR
• Peggy J. Worcester, RN,CCNS
• Timothy R Workman, CDCA
• Joycelyn A Worley, RN
• Ashleigh Worner

• Medical Specialty Clinic/Center in Mansfield, OH
• Providers in Mansfield, OH by specialty
• Medical Specialty Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2011; 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.