WESTSIDE MEDICAL GROUP INC (NPI# 1629016027) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629016027 |
| Entity Type | Organization |
| Organization Name | WESTSIDE MEDICAL GROUP INC |
| Practice Address |
2600 Liberty Heights Ave 1st Floor Baltimore MD 21215-7804 |
| Mailing Address |
Po Box 922 Brooklandville MD 21022-0922 |
| Practice Telephone | 4103834424 |
| Practice Fax Number | 4103837918 |
| Mailing Telephone | 4103834424 |
| Mailing Fax Number | 4103837918 |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | TAJUDEEN OHIOKPEHAI (CEO) |
| Authorized Official Telephone | 4103834424 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | D30115 | MD | Other Service Providers |
| Street Address |
2600 LIBERTY HEIGHTS AVE 1ST FLOOR |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21215-7804 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669448767 | Adeyemisi O Sosanya | Internal Medicine | 2600 Liberty Heights Ave, Baltimore, MD 21215 | 2006-02-27 |
| 1265662795 | Kofi Shaw-taylor Md Pa Westside Medical Group | Urology | 2600 Liberty Heights Ave, Baltimore, MD 21215-7804 | 2009-07-17 |
| 1285874149 | Orthocare Solutions Inc | Durable Medical Equipment & Medical Supplies | 2600 Liberty Heights Ave, Baltimore, MD 21215-7804 | 2009-03-04 |
| 1124219779 | Westside Medical Group L. L. C | Internal Medicine | 2600 Liberty Heights Ave, Baltimore, MD 21215-7804 | 2007-08-08 |
| 1396950911 | Urban Medical Institute | Clinic/Center | 2600 Liberty Heights Ave, Baltimore, MD 21215-7804 | 2007-05-14 |
| 1194930115 | One Heart LLC | Internal Medicine | 2600 Liberty Heights Ave, Baltimore, MD 21215-7804 | 2007-05-12 |
| 1043438716 | Michael Ogbolu | Pathology | 2600 Liberty Heights Ave, Baltimore, MD 21215-7804 | 2007-04-20 |
| 1740408418 | Qualitech Laboratory | Clinical Medical Laboratory | 2600 Liberty Heights Ave, Baltimore, MD 21215-7804 | 2007-04-20 |
| 1578626792 | Bon Secours Hospital-mobile Mri | Clinic/Center | 2600 Liberty Heights Ave, 1st Floor, Baltimore, MD 21215-7804 | 2006-12-18 |
| 1104922913 | Lois Ann Freeman | Nurse Practitioner | 2600 Liberty Heights Ave, One Heart LLC, Baltimore, MD 21215 | 2006-09-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639736796 | Talal Abalkhail | Student in an Organized Health Care Education/Training Program | 2401 W. Belvedere Avenue, Baltimore, Md 21215, Baltimore, MD 21215 | 2019-05-23 |
| 1235795410 | Bilal Khan | Student in an Organized Health Care Education/Training Program | 2041 West Belvedere Avenue, Balitmore, MD 21215 | 2019-05-14 |
| 1669036067 | Nasir M Alhamdan | Student in an Organized Health Care Education/Training Program | Of Baltimore, 2401 West Belvedere Ave, Baltimore, MD 21215 | 2019-05-01 |
| 1851863971 | Brittany Michelle O'neill | Specialist/Technologist | Hearing and Speech Agency, 5900 Metro Drive, Baltimore, MD 21215 | 2018-12-31 |
| 1881164432 | Emily Gamma | Social Worker | 4810 Seton Drive, Baltimore, MD 21215 | 2018-11-27 |
| 1518440478 | Benson Baby | Physical Therapist | 2525west Belveder Ave, Baltimore, MD 21215 | 2018-09-07 |
| 1609360817 | Bonnie Kahler | Clinical Nurse Specialist | 2401 Belvedere Avenue, Baltimore, MD 21215 | 2018-06-20 |
| 1932693843 | Kelley Monica Cohill | Social Worker | Sinai Hospital, Department of Psychiatry, 2440 Cylburn Ave., Baltimore, MD 21215 | 2018-06-15 |
| 1497245609 | Kimberly Beth Koerner | Social Worker | 2401 W. Belvedere Avenue, Baltimore, MD 21215 | 2018-05-14 |
| 1184113078 | Mary Jo Kozel | Registered Nurse | 2401 West Belvedere, Baltimore, MD 21215 | 2018-05-07 |
| Find all providers in zip 21215 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356956593 | Tara Marcell Pettiford | Specialist | 3530 E Northern Pkwy, Baltimore, MD 21206-1632 | 2020-09-14 |
| 1144876806 | Dominic T Mitchell | Specialist | 4626 Kavon Ave, Baltimore, MD 21206-5706 | 2019-08-17 |
| 1164083101 | Chana Cohen | Specialist | 6417 Elray Dr Apt A, Baltimore, MD 21209-2928 | 2019-06-20 |
| 1619477742 | Colleen Marie Berry | Specialist | 7222 Fairbrook Rd, Baltimore, MD 21244-1751 | 2018-02-15 |
| 1104372853 | Clarkview Physicians | Specialist | 1427 Clarkview Road, 300, Baltimore, MD 21209 | 2016-08-31 |
| 1780055343 | Patricia M Disharoon Md | Specialist | 3414 Saint Paul St, Baltimore, MD 21218-2701 | 2015-10-08 |
| 1841673514 | Yen-i Chen | Specialist | 915 S Wolfe St Apt 529, Baltimore, MD 21231-3651 | 2015-06-30 |
| 1891184990 | Sean Raphaely | Specialist | 3619 Glengyle Ave, Baltimore, MD 21215-1556 | 2015-01-13 |
| 1144645862 | Miguel Reyes | Specialist | 11550 Crossroads Cir Unit 424, Baltimore, MD 21220-2975 | 2014-03-04 |
| 1336499722 | Holly A. Nelson, Pediatric Occupational Therapy, LLC | Specialist | 3811 Crestvale Ter, Baltimore, MD 21236-5201 | 2012-09-13 |
| Find all providers in BALTIMORE | ||||
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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.