THEODORE K BREWER (NPI# 1407849375) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407849375 |
| Entity Type | Individual |
| Full Name | THEODORE K BREWER |
| Credential | AA-C |
| Practice Address |
29000 Center Ridge Rd Westlake OH 44145-5293 |
| Mailing Address |
19250 Bagley Rd #101 Cleveland OH 44130-3314 |
| Practice Telephone | 4408275000 |
| Mailing Telephone | 4408918800 |
| Mailing Fax Number | 4408911734 |
| Enumeration Date | 2005-08-25 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367H00000X | Anesthesiologist Assistant | 67-000032 | OH | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | ANTHEM BCBS | 000000334911 | 01 |
| OH | 2253243 | 05 |
| Street Address |
29000 CENTER RIDGE RD |
| City | WESTLAKE |
| State | OH |
| Zip Code | 44145-5293 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255333670 | Roy E Seitz | Emergency Medicine | 29000 Center Ridge Rd, St John Medical Center, Westlake, OH 44145-5293 | 2005-08-15 |
| 1710500103 | Maxwell James Jentsch | Student in an Organized Health Care Education/Training Program | 29000 Center Ridge Rd, Westlake, OH 44145-5219 | 2020-05-20 |
| 1619599586 | Fadel Alkacace | Anesthesiologist Assistant | 29000 Center Ridge Rd, Westlake, OH 44145-5219 | 2020-05-13 |
| 1053932079 | Henry Blunk | Internal Medicine | 29000 Center Ridge Rd, Westlake, OH 44145-5219 | 2020-04-30 |
| 1730709494 | Jessica Wells | Internal Medicine | 29000 Center Ridge Rd, Westlake, OH 44145-5219 | 2020-04-23 |
| 1750910956 | Golnaz Lahsaee | Internal Medicine | 29000 Center Ridge Rd, Westlake, OH 44145-5219 | 2020-04-08 |
| 1295364669 | Jessica Kallenborn | Student in an Organized Health Care Education/Training Program | 29000 Center Ridge Rd, Westlake, OH 44145-5219 | 2020-04-07 |
| 1427687078 | Jordan Thomas Felice | Internal Medicine | 29000 Center Ridge Rd, Westlake, OH 44145-5219 | 2020-04-06 |
| 1194354894 | Rachel Kamat | Student in an Organized Health Care Education/Training Program | 29000 Center Ridge Rd, Westlake, OH 44145-5219 | 2020-04-04 |
| 1124667803 | Angela Yako | Nurse Anesthetist, Certified Registered | 29000 Center Ridge Rd, Westlake, OH 44145-5219 | 2019-12-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720628902 | Inherent Basic Goodness Counseling, LLC | Social Worker | 24600 Center Ridge Road Suite 130, Westlake, OH 44145 | 2020-01-15 |
| 1700425030 | The Family Dentist of Westlake Jonathan J Klineman Dds Inc | Dentist | 26600 Detroit Rd Suite 230, Westlake, OH 44145 | 2020-01-03 |
| 1033772421 | Holding Space, LLC | Social Worker | 26404 Center Ridge Rd Building A1 Ste A7, Westlake, OH 44145 | 2019-04-21 |
| 1326532508 | Integrative Pain Care LLC | Durable Medical Equipment & Medical Supplies | 25200 Center Ridge Rd, Ste 3300, Westlake, OH 44145 | 2018-06-20 |
| 1841783990 | Wendy Lynn Wheeler | Counselor | 28263 Center Ridge Rd, Westlake, OH 44145 | 2018-06-13 |
| 1326557836 | Tiffany Manrodt | Social Worker | 24500 Center Ridge Road Bldg 4, #120, Westlake, OH 44145 | 2017-09-27 |
| 1639620792 | Stacy Ryan | Speech-Language Pathologist | 3057 Holly Lane, Westlake, OH 44145 | 2016-10-24 |
| 1790238954 | Kathleen Hanigosky | Pharmacist | 27175 Center Ridge Rd., Westlake, OH 44145 | 2016-07-25 |
| 1780073155 | Prominent Healthcare, Inc. | Community/Behavioral Health | 24650 Westlake Center Ridge Road, Westlake, OH 44145 | 2015-01-22 |
| 1902225022 | Amanda Brooke Abernathy | Physical Therapist | 850 Columbia Road, Suite #110, Westlake, OH 44145 | 2014-04-16 |
| Find all providers in zip 44145 | ||||
| Taxonomy Code | 367H00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Anesthesiologist Assistant |
| An individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants are required to have a bachelor's degree with a premed curriculum prior to entering a two-year anesthesiology assistant program, which is focused upon the delivery and maintenance of anesthesia care as well as advanced patient monitoring techniques. An Anesthesiologist Assistant must work as a member of the anesthesia care team under the direction of a qualified Anesthesiologist. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619599586 | Fadel Alkacace | Anesthesiologist Assistant | 29000 Center Ridge Rd, Westlake, OH 44145-5219 | 2020-05-13 |
| 1942514369 | Michelle Lynn Mccourt | Anesthesiologist Assistant | 850 Columbia Rd, Westlake, OH 44145-1493 | 2010-07-27 |
| 1326182767 | Jayati Thamilarasan | Anesthesiologist Assistant | 850 Columbia Rd, Westlake, OH 44145-1493 | 2007-02-19 |
| 1790741015 | Carol A Thierry | Anesthesiologist Assistant | 29000 Center Ridge Rd, Westlake, OH 44145-5293 | 2006-04-25 |
| 1942293824 | Melvin J Woodard IIi | Anesthesiologist Assistant | 29000 Center Ridge Rd, Westlake, OH 44145-5293 | 2005-08-26 |
| 1770576605 | Matthew R Levin | Anesthesiologist Assistant | 29000 Center Ridge Rd, Westlake, OH 44145-5293 | 2005-08-25 |
| 1104819028 | Jay R Blackmur | Anesthesiologist Assistant | 29000 Center Ridge Rd, Westlake, OH 44145-5293 | 2005-08-25 |
| 1154314094 | Jeffrey P Scavelli | Anesthesiologist Assistant | 29000 Center Ridge Rd, Westlake, OH 44145-5293 | 2005-08-25 |
| 1316930258 | Chris E Thomascik | Anesthesiologist Assistant | 29000 Center Ridge Rd, Westlake, OH 44145-5293 | 2005-08-25 |
| 1255333282 | Dejan Zivkovic | Anesthesiologist Assistant | 850 Columbia Rd, Westlake, OH 44145-1493 | 2005-08-10 |
| Find all providers in WESTLAKE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.