Family Practice Center Wooster Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

35077914M Issued in OH

Legal business name

FAMILY PRACTICE CENTER WOOSTER INC

Practice address

128 E Milltown Rd
Suite 205
Wooster, OH 44691-6109

Phone

(330) 345-2008

Fax

(330) 345-0056

NPI assigned

Mar 6, 2008

Organization subpart

No

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

Authorized official

Name

Raymond Gregory Mason, M.D.

Title

President

Phone

(330) 345-2008

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1204761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400630400000",
    "number": "1952571937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 E MILLTOWN RD STE 205",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446911276",
            "telephone_number": "330-345-2008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 E MILLTOWN RD",
            "address_2": "SUITE 205",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446916109",
            "telephone_number": "330-345-2008",
            "fax_number": "330-345-0056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY PRACTICE CENTER WOOSTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-06",
        "last_updated": "2014-05-21",
        "status": "A",
        "authorized_official_last_name": "MASON",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "GREGORY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "330-345-2008",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35077914M",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CK7409",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2211645",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kateri M Ewing, LISW
• Anne Marie Ezra
• Alexis Falb
• Scott Falkenberg
• Family Eye Care of Wooster LLC
• Whitney Fanello, PTA
• Gillian Grace Fannin
• Trinity D Faries
• Cordelia Farmer
• Jeanna Marie Fascione, DPM

• Family Medicine Physician in Wooster, OH
• Providers in Wooster, 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 May 21, 2014; 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.