Ohio Independent Collaborative, LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

OHIO INDEPENDENT COLLABORATIVE, LLC

Practice address

24651 Center Ridge Rd
Suite 350
Westlake, OH 44145-5635

Phone

(440) 895-5056

NPI assigned

Jan 29, 2016

Organization subpart

No

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

Authorized official

Name

Robert Kent, DO

Title

Chairman

Phone

(330) 929-2685

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1454025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454284800000",
    "number": "1902264476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24651 CENTER RIDGE RD",
            "address_2": "SUITE 350",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441455635",
            "telephone_number": "440-895-5056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24651 CENTER RIDGE RD",
            "address_2": "SUITE 350",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441455635",
            "telephone_number": "440-895-5056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OHIO INDEPENDENT COLLABORATIVE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-29",
        "last_updated": "2016-02-01",
        "status": "A",
        "authorized_official_last_name": "KENT",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "CHAIRMAN",
        "authorized_official_telephone_number": "330-929-2685",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Westlake, OH
• Providers in Westlake, OH by specialty
• General Practice Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2016; 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.