OUTREACH PROFESSIONAL SERVICES INC (NPI# 1356523963) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356523963 |
| Entity Type | Organization |
| Organization Name | OUTREACH PROFESSIONAL SERVICES INC |
| Other Organization Name | CUYAHOGA PHYSICIAN NETWORK |
| Practice Address |
29325 Health Campus Dr Suite 1 Westlake OH 44145 |
| Mailing Address |
26908 Detroit Rd Suite 301 Westlake OH 44145-2398 |
| Practice Telephone | 4408356996 |
| Practice Fax Number | 4408089738 |
| Mailing Telephone | 4406171823 |
| Mailing Fax Number | 4406170884 |
| Enumeration Date | 2007-12-05 |
| Last Update Date | 2010-01-12 |
| Authorized Official Name | MISTY A BLAYLOCK (CREDENTIALING COORDINATOR) |
| Authorized Official Telephone | 4408926406 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 367A00000X | Advanced Practice Midwife | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0251856 | 05 |
| Other Name | Type Code |
|---|---|
| Cuyahoga Physician Network | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033391792 | Outreach Professional Services Inc | Orthopaedic Surgery | 14601 Detroit Rd, Suite 640, Lakewood, OH 44107 | 2007-12-04 |
| 1184916033 | Outreach Professional Services Inc | Durable Medical Equipment & Medical Supplies | 6701 Rockside Rd, Suite 100, Independence, OH 44131-2358 | 2011-05-11 |
| 1053599209 | Outreach Professional Services Inc | Neurological Surgery | 5334 Meadow Lane Ct, Sheffield Village, OH 44035-1469 | 2008-02-08 |
| 1770765380 | Outreach Professional Services Inc | Orthopaedic Surgery | 33141 Bainbridge Rd, Solon, OH 44139 | 2007-12-05 |
| 1780866392 | Outreach Professional Services Inc | Internal Medicine | 2322 East 22nd St, Suite 200, Cleveland, OH 44115 | 2007-12-05 |
| 1326220930 | Outreach Professional Services Inc | Anesthesiology | 2351 East 22nd St, Cleveland, OH 44115 | 2007-12-05 |
| 1952583627 | Outreach Professional Services Inc | Durable Medical Equipment & Medical Supplies | 6701 Rockside Rd, Suite 103, Independence, OH 44131-2358 | 2007-12-04 |
| 1396927067 | Outreach Professional Services Inc | Surgery | 4415 Euclid Ave, Suite 110, Cleveland, OH 44103 | 2007-12-04 |
| 1104008879 | Outreach Professional Services Inc | Internal Medicine | 11201 Shaker Blvd, Suite 102, Cleveland, OH 44104 | 2007-12-04 |
| 1780866467 | Outreach Professional Services Inc | Internal Medicine | 2322 East 22nd St, Suite 207, Cleveland, PA 44145 | 2007-12-04 |
| Street Address |
29325 HEALTH CAMPUS DR SUITE 1 |
| City | WESTLAKE |
| State | OH |
| Zip Code | 44145 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770581787 | Mansour S Isckarus | Internal Medicine | 29325 Health Campus Dr, Suite #1, Westlake, OH 44145-8201 | 2005-07-13 |
| 1780022103 | Center for Orthopedics, Inc | Durable Medical Equipment & Medical Supplies | 29325 Health Campus Dr, Suite 3, Westlake, OH 44145-8201 | 2013-06-07 |
| 1013210079 | Westshore Primary Care Assoc., Inc. | Obstetrics & Gynecology | 29325 Health Campus Dr, Suite 1, Westlake, OH 44145-8201 | 2010-12-14 |
| 1285945030 | Katherine Hovsepian Eilenfeld | Internal Medicine | 29325 Health Campus Dr, Suite 2, Westlake, OH 44145-8201 | 2010-06-27 |
| 1790892792 | Westshore Primary Care Assoc Inc | Family Medicine | 29325 Health Campus Dr, Ste 2, Westlake, OH 44145 | 2006-08-24 |
| 1508808155 | Lori A Rusterholtz | Internal Medicine | 29325 Health Campus Dr, Suite 3, Westlake, OH 44145-8201 | 2006-06-11 |
| 1316997372 | Asif A Chaudhry | Internal Medicine | 29325 Health Campus Dr, Westlake, OH 44145-8201 | 2006-05-11 |
| 1891765186 | Mohammed Sunallah Khan | Internal Medicine | 29325 Health Campus Dr, Suite 3, Westlake, OH 44145-8201 | 2006-01-26 |
| 1003886755 | Robert John Krajcik | Family Medicine | 29325 Health Campus Dr, Suite 3, Westlake, OH 44145-8201 | 2006-01-25 |
| 1790774099 | Mary C Revolinsky | Family Medicine | 29325 Health Campus Dr, Ste 2, Westlake, OH 44145-8201 | 2005-10-19 |
| 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 | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427404227 | Jillian Dodge | Obstetrics & Gynecology | 850 Columbia Rd Ste 330, Westlake, OH 44145-7215 | 2016-05-11 |
| 1396162509 | Lauren Blech | Obstetrics & Gynecology | 850 Columbia Rd Bldg A, Westlake, OH 44145 | 2014-03-25 |
| 1700184447 | Jagannath Das | Obstetrics & Gynecology | 1029 Dominion Drive, Westlake, OH 44145 | 2011-03-04 |
| 1740480300 | Rima Bachuwa | Obstetrics & Gynecology | 2211 Crocker Rd Ste 130, Westlake, OH 44145-7603 | 2007-07-23 |
| 1669554986 | Robert Bradley Lucas | Obstetrics & Gynecology | 960 Clague Rd Ste 1100a, Westlake, OH 44145-1590 | 2006-10-19 |
| 1659462778 | Kamrul Hasan | Obstetrics & Gynecology | 26633 Detroit Rd, Westlake, OH 44145 | 2006-09-27 |
| 1376526731 | Wendy J Freedman | Obstetrics & Gynecology | 29160 Center Ridge Rd, Ste. M, Westlake, OH 44145-5225 | 2005-11-21 |
| 1467441501 | Regina Hill | Obstetrics & Gynecology | 805 Columbia Rd Ste 105, Westlake, OH 44145-1461 | 2005-10-20 |
| 1538625439 | Westside Womens Medicine | Obstetrics & Gynecology | 805 Columbia Rd Ste 105, Westlake, OH 44145-1461 | 2019-02-15 |
| 1972905867 | Obgyn of Westlake, LLC | Obstetrics & Gynecology | 2211 Crocker Rd Ste 130, Westlake, OH 44145-7603 | 2014-09-23 |
| 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.