OTIS MARK HASTINGS (NPI# 1831146463) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831146463 |
| Entity Type | Individual |
| Full Name | OTIS MARK HASTINGS |
| Credential | M.D. |
| Practice Address |
14519 Detroit Ave Lakewood OH 44107-4316 |
| Mailing Address |
28625 Woodmill Dr Westlake OH 44145-2085 |
| Practice Telephone | 2165214200 |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2008-05-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 35059241H | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | ANTHEM BC/BS | 000000380930 | 01 |
| OH | WELLCARE | 378646 | 01 |
| OH | MEDICARE TRAVELERS RR-GA | 930007405 | 01 |
| OH | 0798329 | 05 | |
| OH | CARESOURCE | 341542312098 | 01 |
| OH | CARESOURCE | 942460636261 | 01 |
| Street Address |
14519 DETROIT AVE |
| City | LAKEWOOD |
| State | OH |
| Zip Code | 44107-4316 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902895493 | Umarani Ramachandran | Pediatrics | 14519 Detroit Ave, Lakewood, OH 44107-4316 | 2005-10-18 |
| 1831584804 | Michelle Palcsik | Dietitian, Registered | 14519 Detroit Ave, Lakewood, OH 44107-4316 | 2015-04-06 |
| 1114318029 | Jessica Schreiner | Dietitian, Registered | 14519 Detroit Ave, Lakewood, OH 44107-4316 | 2015-02-13 |
| 1932516424 | Beth Tibbitts | Social Worker | 14519 Detroit Ave, Lakewood, OH 44107-4316 | 2014-07-16 |
| 1811309461 | Jessica Bennett | Physical Therapist | 14519 Detroit Ave, Lakewood, OH 44107-4316 | 2014-05-29 |
| 1104238237 | Michelle Kellicker | Physical Therapist | 14519 Detroit Ave, Lakewood, OH 44107-4316 | 2014-05-23 |
| 1386056687 | Andrew Morgan Cluts | Physical Therapist | 14519 Detroit Ave, Lakewood, OH 44107-4316 | 2014-05-21 |
| 1558772103 | Tamara Hunt | Physical Therapist | 14519 Detroit Ave, Lakewood, OH 44107-4316 | 2014-05-16 |
| 1114338001 | Kristen Louise Gallo | Physical Therapist | 14519 Detroit Ave, Lakewood, OH 44107-4316 | 2014-05-13 |
| 1902216773 | Timothy Hirzel | Physical Therapist | 14519 Detroit Ave, Lakewood, OH 44107-4316 | 2014-05-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326522210 | Lawrence M Roth | Social Worker | 14701 Detroit Ave Ste 363, Lakewood, OH 44107 | 2018-09-18 |
| 1376065730 | Fareeha Khan | Internal Medicine | 12540 Edgewater Drive, Apt 411, Lakewood, OH 44107 | 2017-07-07 |
| 1912433756 | Julie Ann Foucher-urcuyo | Family Medicine | 14601 Detroit Ave, Fl 2, Lakewood, OH 44107 | 2017-05-11 |
| 1225563661 | Elizabeth Ann Rainbolt | Family Medicine | 14601 Detroit Ave Fl 2, Lakewood, OH 44107 | 2017-04-24 |
| 1255882551 | Kristen Murray | Dietitian, Registered | 14900 Detroit Ave Ste 207, Lakewood, OH 44107 | 2016-10-21 |
| 1265828131 | David Thomas Jonke | Dentist | 15640 Madison Ave., Lakewood, OH 44107 | 2015-04-08 |
| 1760885941 | Debra Watkins | Home Health Aide | 1510 Newman Ave Apt 406, Lakewood, OH 44107 | 2014-10-02 |
| 1396155198 | Monica M Owen | Occupational Therapist | 9200 Biddulph Rd., Brooklyn, OH 44107 | 2014-05-01 |
| 1730512229 | Marsha Elaine Favors | Licensed Practical Nurse | 1448 Lakeland Ave, Lakewood, OH 44107 | 2013-08-20 |
| 1508130006 | Ruth Rachel Raciniewski | Counselor | 15200 Madison Avenue, Lakewood, OH 44107 | 2012-03-01 |
| Find all providers in zip 44107 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992330484 | Usacs Community Emergency Services of Colorado, Inc. | Emergency Medicine | 3280 S Wadsworth Blvd, Lakewood, CO 80227-5002 | 2020-03-05 |
| 1235507724 | Justin Evans | Emergency Medicine | 476 Newland St, Lakewood, CO 80226 | 2015-09-14 |
| 1518376151 | Karthikeyan Muthuswamy | Emergency Medicine | St Clare Hospital Emergency Department, 11315 Bridgeport Way Sw, Lakewood, WA 98499 | 2014-08-07 |
| 1114193513 | Ryan Matthew Klemt | Emergency Medicine | 550 S Wadsworth Blvd Unit 410, Brighton Community Emergency Physicians; C/o Emms, Lakewood, CO 80226-3118 | 2008-05-06 |
| 1255365078 | Charles A Cole | Emergency Medicine | 550 S. Wadsworth Ave, Lakewood, CO 80266-3118 | 2006-07-10 |
| 1881622074 | Hillel Peltz | Emergency Medicine | 940 Somerset Ave, Lakewood, NJ 08701-2130 | 2006-06-28 |
| 1578507042 | Carmen James Corrall II | Emergency Medicine | 5700 100th St Sw Ste 510, Lakewood, WA 98499-2767 | 2006-06-15 |
| 1659315307 | William Dalsey | Emergency Medicine | Kimball Medical Center (emergency Department), 600 River Avenue, Lakewood, NJ 08701 | 2006-06-15 |
| 1427099027 | Richard Arnold Nelson | Emergency Medicine | 14519 Detroit Avenue, Lakewood, OH 44107-4316 | 2006-06-08 |
| 1457301897 | Charles E Goodell | Emergency Medicine | 14062 Denver West Pkwy, Ste 150, Lakewood, CO 80401-3109 | 2006-05-10 |
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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.