MARK J GIPSON (NPI# 1629070511) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629070511 |
| Entity Type | Individual |
| Full Name | MARK J GIPSON |
| Credential | MD |
| Practice Address |
26908 Detroit Rd Suite 200 Westlake OH 44145-2398 |
| Mailing Address |
26908 Detroit Rd Suite 301 Westlake OH 44145-2398 |
| Practice Telephone | 4402508660 |
| Practice Fax Number | 4402508639 |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2016-09-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 35051727 | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0607703 | 05 | |
| OH | RR MEDICARE | 370017679 | 01 |
| Street Address |
26908 DETROIT RD SUITE 200 |
| City | WESTLAKE |
| State | OH |
| Zip Code | 44145-2398 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235139767 | Michael A Adornetto | Internal Medicine | 26908 Detroit Rd, Ste 200, Westlake, OH 44145 | 2005-07-27 |
| 1063815587 | Lisa Brown | Nurse Practitioner | 26908 Detroit Rd, Suite 200, Westlake, OH 44145-2398 | 2014-09-29 |
| 1518368034 | Julie Wise | Dietitian, Registered | 26908 Detroit Rd, Suite 200, Westlake, OH 44145-2398 | 2014-09-16 |
| 1649689639 | Karen Moore | Nurse Practitioner | 26908 Detroit Rd, Suite 301, Westlake, OH 44145-2398 | 2014-08-05 |
| 1871904227 | Brittany Morgan Peters | Nurse Practitioner | 26908 Detroit Rd, Ste. 200, Westlake, OH 44145-2398 | 2014-05-19 |
| 1144650227 | Vanessa Duber | Nurse Practitioner | 26908 Detroit Rd, Suite 200, Westlake, OH 44145-2398 | 2013-11-26 |
| 1649610114 | Muhammad Raihan Malik | Internal Medicine | 26908 Detroit Rd, Ste. 200, Westlake, OH 44145-2398 | 2013-06-28 |
| 1467796417 | Julie Ellen Bradford | Nurse Practitioner | 26908 Detroit Rd, Ste. 200, Westlake, OH 44145-2398 | 2012-11-15 |
| 1679825947 | Maxine Paulraj-charles | Nurse Practitioner | 26908 Detroit Rd, Ste. 200, Westlake, OH 44145-2398 | 2012-10-10 |
| 1942564802 | Mary E Klecka | Internal Medicine | 26908 Detroit Rd, Ste. 200, Westlake, OH 44145-2398 | 2012-06-26 |
| 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 | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033641774 | Susan R Liu | Pediatrics | 805 Columbia Rd Ste 102, Westlake, OH 44145-1461 | 2017-03-31 |
| 1053582882 | Monica Garcia Hoban | Pediatrics | 1547 Barclay Blvd, Westlake, OH 44145-6825 | 2008-03-19 |
| 1457452997 | Thomas Wasserbauer | Pediatrics | 29099 Health Campus Dr Ste 180, Westlake, OH 44145-5299 | 2006-09-26 |
| 1033219134 | Amy Carruthers | Pediatrics | 960 Clague Rd Ste 185, Westlake, OH 44145-1582 | 2006-09-25 |
| 1851490528 | Marcia Columbro | Pediatrics | 960 Clague Rd Ste 1850, Westlake, OH 44145-7705 | 2006-09-21 |
| 1255435798 | John Bennet II | Pediatrics | 26040 Detroit Rd, Suite 7, Westlake, OH 44145-2481 | 2006-09-12 |
| 1487604369 | Suzanne D Connolly | Pediatrics | 805 Columbia Rd, Suite 102, Westlake, OH 44145-1487 | 2006-05-11 |
| 1578528196 | Catherine D Arora | Pediatrics | 2001 Crocker Rd Ste 600, Westlake, OH 44145-6972 | 2006-04-18 |
| 1659515500 | Valerie C Fouts-fowler | Pediatrics | 2001 Crocker Rd Ste 600, Westlake, OH 44145-6972 | 2009-04-22 |
| 1790984664 | Susan Marie O'rourke | Pediatrics | 29000 Center Ridge Rd, Westlake, OH 44145-5293 | 2007-07-12 |
| 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.