WESTERN RESERVE PROFESSIONAL GROUP INC


Address: 307 West Main Street, Suite C, Kent, OH 44240-2400
Phone: 3306773628

WESTERN RESERVE PROFESSIONAL GROUP INC (NPI# 1699986620) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1699986620
Entity Type Organization
Organization Name WESTERN RESERVE PROFESSIONAL GROUP INC
Other Organization Name THE SPINE & PAIN INSTITUTE
Practice Address 307 West Main Street
Suite C
Kent
OH 44240-2400
Mailing Address Po Box 715479
Columbus
OH 43271-5479
Practice Telephone 3306773628
Practice Fax Number 3306774931
Mailing Telephone 3306773628
Mailing Fax Number 3306774931
Enumeration Date 2007-05-24
Last Update Date 2014-01-15
Authorized Official Name RACHELLE ANN LIGHT (OFFICE COORDINATOR)
Authorized Official Telephone 3306773628
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 111NX0800X Chiropractor
Specialization: Orthopedic
Chiropractic Providers
N 208100000X Physical Medicine & Rehabilitation Allopathic & Osteopathic Physicians
N 208VP0014X Pain Medicine
Specialization: Interventional Pain Medicine
Allopathic & Osteopathic Physicians
N 225100000X Physical Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Y 2081P2900X Physical Medicine & Rehabilitation
Specialization: Pain Medicine
Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
OH 0926887 05
OH 2675921 05
OH 2311331 05
OH 2493038 05
OH 2406275 05
OH 4085673 05
OH 0251070 05
OH 2082866 05

Other Provider/Organization Names

Other Name Type Code
The Spine & Pain Institute Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1538126693 Western Reserve Professional Group Inc Physical Medicine & Rehabilitation 174 Currie Hall Pkwy, Ste D, Kent, OH 44240-4387 2006-05-01

Office Location

Street Address 307 WEST MAIN STREET
SUITE C
City KENT
State OH
Zip Code 44240-2400

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1881201887 Julia Repasky Speech-Language Pathologist 4170 Oh-43, Kent, OH 44240 2020-09-24
1811515000 Natasha Loveridge Speech-Language Pathologist 1949 Oh-59, Suite 202, Kent, OH 44240 2020-07-14
1215569256 Meijer Stores Limited Partnership Durable Medical Equipment & Medical Supplies 247 Tallmadge Rd., Kent, OH 44240 2020-02-07
1710526702 Rebecca K Cibik Pediatrics 2497 State Route 59, Kent, OH 44240 2019-12-23
1073099834 Sean Joseph Hiemstra Case Manager/Care Coordinator 5982 Rhodes Road Kent Ohio 44240, Kent, OH 44240 2018-07-16
1740798081 Mason Brain Yoder Counselor 1025 Erin Drive, Kent, OH 44240 2018-01-22
1710405055 Ashley Barczok Nurse Practitioner 5982 Rhodes Road, Kent, OH 44240 2017-09-07
1073963930 Kimberly Ruth Griffith Counselor 190 Currie Hall Pkwy Ste A, Kent, OH 44240 2016-06-21
1801257456 Ra'mone Williams Audiologist 717 Beryl Dr, Kent, OH 44240 2016-03-10
1730546615 Christina Cole Nurse Practitioner 1675 E Main St Ste 328, Kent, OH 44240 2016-01-22
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Taxonomy Information

Taxonomy Code 2081P2900X
Grouping Allopathic & Osteopathic Physicians
Classification Physical Medicine & Rehabilitation
Specialization Pain Medicine

Taxonomy Definition

A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed] Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. A subspecialty certificate was approved by the ABMS in 1999. ACGME Accredited Residency Program Requirements: Proposal under development.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1780768820 Western Reserve Professional Group Physical Medicine & Rehabilitation 401 Devon Pl, Kent, OH 44240-6482 2006-10-25
1588745632 Western Reserve Professional Group Physical Medicine & Rehabilitation 5700 Darrow Road, Suite 109, Kent, OH 44240 2006-10-17
1184726903 Ann Rosemary Crawford Physical Medicine & Rehabilitation 24031 104th Ave Se, Kent, WA 98030-4975 2006-09-02
1538126693 Western Reserve Professional Group Inc Physical Medicine & Rehabilitation 174 Currie Hall Pkwy, Ste D, Kent, OH 44240-4387 2006-05-01

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1386287936 Novus Pain Management - Ohio LLC Physical Medicine & Rehabilitation 100 N Main St Ste 350, Chagrin Falls, OH 44022-2773 2019-10-25
1396218558 Health Intrinsic Technology LLC Physical Medicine & Rehabilitation 41 Brookline Ave, Youngstown, OH 44505-2530 2019-01-09
1760884399 Patrick T Boylan Md Inc Physical Medicine & Rehabilitation 9485 Mentor Ave Ste 203, Mentor, OH 44060-8723 2014-09-26
1750513867 Comprehensive Pain Management & Electrodiagnostics, LLC Physical Medicine & Rehabilitation 80 N Portage Path, #ph7, Akron, OH 44303-1144 2009-08-23
1962654731 James Edgar Lundeen Sr. Physical Medicine & Rehabilitation 26 Sandusky St, Plymouth, OH 44865-1113 2008-10-10
1679777528 Kush Kumar Goyal Physical Medicine & Rehabilitation 1730 W 25th St # 2c, Center for Spine Health- Lutheran Hospital, Cleveland, OH 44113-3108 2007-06-13
1841316163 University Primary Care Practices Inc Physical Medicine & Rehabilitation 50 Blaine Ave Ste 2300, Bedford, OH 44146-2709 2007-03-21
1467594986 Tarulata M Patel Physical Medicine & Rehabilitation 50 Normandy Drive Suite #3, Liberty Medical Center, Painesville, OH 44077 2007-02-12
1184766602 Maheshkumar P. Patel Physical Medicine & Rehabilitation 26250 Euclid Avenue, Suite 625, Euclid, OH 44132 2007-02-12
1205985967 Southwest General Medical Group, Inc Physical Medicine & Rehabilitation 18780 Bagley Rd # 100, Cleveland, OH 44130-3304 2007-01-10
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Competitor

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City KENT
Zip Code 44240

Improve Information

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Dataset Information

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.

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