JAMES P. FRACKELTON, MD, INC (NPI# 1366642498) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1366642498 |
Entity Type | Organization |
Organization Name | JAMES P. FRACKELTON, MD, INC |
Other Organization Name | PREVENTIVE MEDICINE GROUP |
Practice Address |
24700 Center Ridge Rd Westlake OH 44145-5636 |
Practice Telephone | 4408350104 |
Practice Fax Number | 4408352177 |
Mailing Telephone | 4408350104 |
Mailing Fax Number | 4408352177 |
Enumeration Date | 2007-07-18 |
Last Update Date | 2007-07-18 |
Authorized Official Name | SUSAN ANN WENGER (MANAGER) |
Authorized Official Telephone | 4408352150 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
Other Name | Type Code |
---|---|
Preventive Medicine Group | Doing Business As Name - Organization |
Street Address |
24700 CENTER RIDGE RD |
City | WESTLAKE |
State | OH |
Zip Code | 44145-5636 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1427064567 | James William Moodt | Dentist | 24700 Center Ridge Rd, One King James South, Suite #19, Westlake, OH 44145-5636 | 2006-07-31 |
1194868893 | Derrick Lonsdale | Family Medicine | 24700 Center Ridge Rd, Suite 317, Westlake, OH 44145-5636 | 2007-02-14 |
1033257258 | John Michael Telzrow | Psychologist | 24700 Center Ridge Rd, Suite 314, Westlake, OH 44145-5636 | 2007-02-01 |
1134273808 | King James Medical Laboratory Inc | Clinical Medical Laboratory | 24700 Center Ridge Rd, Suite 113, Westlake, OH 44145-5636 | 2007-01-22 |
1205989357 | Richard Joseph Ballas | Dentist | 24700 Center Ridge Rd, Westlake, OH 44145-5636 | 2007-01-20 |
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 | 208D00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | General Practice |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1396040796 | Percival D Seaward | General Practice | 2931 Forest Lake Dr, Westlake, Westlake, OH 44145-1783 | 2011-01-14 |
1215105614 | Swatantra L Adusumilli | General Practice | 25678 Woodpath Trl, Westlake, OH 44145-5705 | 2008-02-19 |
1902264476 | Ohio Independent Collaborative, LLC | General Practice | 24651 Center Ridge Rd, Suite 350, Westlake, OH 44145-5635 | 2016-01-29 |
1487910857 | George K. Mathew, M.d., Inc. | General Practice | 29099 Health Campus Dr, Suite #230, Westlake, OH 44145-5200 | 2012-04-10 |
1487859161 | George K Mathew | General Practice | 29099 Health Campus Dr, Suite-230, Westlake, OH 44145-5200 | 2007-06-20 |
1598750705 | Jerome Ngangana | General Practice | 29000 Center Ridge Rd, St John West Shore Hospital, Westlake, OH 44145-5293 | 2005-09-14 |
1760476709 | Ian Kletter | General Practice | 29000 Center Ridge Rd, St John West Shore Hospital, Westlake, OH 44145-5293 | 2005-09-06 |
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1437788874 | Syed, LLC | General Practice | 366 Birchbrook Ct, Centerville, OH 45458-9718 | 2020-04-07 |
1982237681 | Hydreight Usa LLC | General Practice | 16738 Pearl Rd, Strongsville, OH 44136-6049 | 2020-02-20 |
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1437796042 | Integrated Medicine of Ohio LLC | General Practice | 2780 S Arlington Rd Ste 202, Coventry Township, OH 44312-4707 | 2019-12-02 |
1265078497 | Jaime L Go Md Inc | General Practice | 1200 Resource Dr, Brooklyn Hts, OH 44131-1849 | 2019-11-22 |
1558902809 | Wecare Health Clinic Group, LLC | General Practice | 8918 Reading Rd, Cincinnati, OH 45215-3228 | 2019-10-07 |
1063062354 | Independent Physical Medicine LLC | General Practice | 3469 W Elm St, Lima, OH 45807-2226 | 2019-09-18 |
1861041535 | Allied Medical Integration, LLC | General Practice | 7067 Tiffany Blvd Ste 280, Poland, OH 44514-1803 | 2019-09-05 |
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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.