Northcoast Medical Group LLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

34-007383 Issued in OH

Legal business name

NORTHCOAST MEDICAL GROUP LLC

Practice address

5325 Som Center Rd
Solon, OH 44139-1459

Phone

(440) 785-5278

NPI assigned

Nov 6, 2012

Organization subpart

No

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

Authorized official

Name

Teresa Larsen, D.O.NPI 1457467003

Title

Owner

Phone

(440) 785-5278

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Teresa Kay Larsen, D.O.

  • Physical Medicine & Rehabilitation Physician
  • Solon, OH
  • NPI 1457467003
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1352160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352246400000",
    "number": "1992059380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5325 SOM CENTER RD",
            "city": "SOLON",
            "state": "OH",
            "postal_code": "441391459",
            "telephone_number": "440-785-5278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5325 SOM CENTER RD",
            "city": "SOLON",
            "state": "OH",
            "postal_code": "441391459",
            "telephone_number": "440-785-5278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHCOAST MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-06",
        "last_updated": "2012-11-07",
        "status": "A",
        "authorized_official_last_name": "LARSEN",
        "authorized_official_first_name": "TERESA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "440-785-5278",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "OH",
            "license": "34-007383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erica Newson
• Amanda E Nichols, CNP
• Natasha M Nichols, LPCC-S, BC-TMH
• Nicole J. Malie LLC
• Neptina P Nixon
• Muneera Y Novak, LISW
• William Victor O'Boyle, LPCC-S
• Kelsey Grace O'Neal
• Oboylecounselingllc
• Barry Ohearn, RN

• Physical Medicine & Rehabilitation Physician in Solon, OH
• Providers in Solon, OH by specialty
• Physical Medicine & Rehabilitation Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2012; 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.