EMERGENCY MEDICINE PHYSICIANS OF LAKE MEDINA, LTD (NPI# 1669759957) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669759957 |
| Entity Type | Organization |
| Organization Name | EMERGENCY MEDICINE PHYSICIANS OF LAKE MEDINA, LTD |
| Practice Address |
3780 Medina Rd Medina OH 44256-9311 |
| Mailing Address |
4535 Dressler Rd Nw Canton OH 44718-2545 |
| Practice Telephone | 8775047849 |
| Mailing Telephone | 3304934443 |
| Mailing Fax Number | 3304938677 |
| Enumeration Date | 2011-11-15 |
| Last Update Date | 2011-11-15 |
| Authorized Official Name | DAVID C PACKO (PRESIDENT) |
| Authorized Official Telephone | 3304934443 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
3780 MEDINA RD |
| City | MEDINA |
| State | OH |
| Zip Code | 44256-9311 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386634681 | Ruchi Taliwal | Family Medicine | 3780 Medina Rd, Medina, OH 44256-9311 | 2005-10-27 |
| 1215582705 | Summa Health System | Clinic/Center | 3780 Medina Rd, Medina, OH 44256-9311 | 2019-08-02 |
| 1427600493 | Melissa Marie Sapper | Nurse Practitioner | 3780 Medina Rd, Medina, OH 44256-9311 | 2019-07-10 |
| 1255813010 | Barbara R. Kinney | Nurse Practitioner | 3780 Medina Rd, Medina, OH 44256-9311 | 2018-08-29 |
| 1689115016 | Kristina Lalley | Nurse Practitioner | 3780 Medina Rd, Medina, OH 44256-9311 | 2017-03-18 |
| 1437690203 | Mary-claire Howarth | Nurse Practitioner | 3780 Medina Rd, Suite 310, Medina, OH 44256 | 2017-03-13 |
| 1881047702 | Brianne Patton | Physician Assistant | 3780 Medina Rd, Suite 250, Medina, OH 44256-9311 | 2016-07-15 |
| 1295114809 | Np Medical Solutions LLC | Registered Nurse | 3780 Medina Rd, Ste# 310, Medina, OH 44256-9311 | 2015-05-28 |
| 1679901268 | Summa Emergency Associates, Inc. | Emergency Medicine | 3780 Medina Rd, Medina, OH 44256-9311 | 2013-10-17 |
| 1013285907 | Katharine Rice Chapman | Nurse Practitioner | 3780 Medina Rd, Suite 310, Medina, OH 44256-9311 | 2011-12-06 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215577408 | Phil Mcclelland | Counselor | 520 Miller Dr, Medina, OH 44256 | 2020-01-15 |
| 1619519444 | Lauren Marie Blakney | Nurse Practitioner | 970 E Washington St., Medina, OH 44256 | 2019-10-14 |
| 1558922286 | Jennifer Sue Arhin | Nurse Practitioner | 807 E Washington St., Ste 220, Medina, OH 44256 | 2019-06-24 |
| 1891263927 | Jena Christine Palmer | Nurse Practitioner | 817 E Washington Street, Medina, OH 44256 | 2018-11-07 |
| 1154849891 | Janelle Liggett-schultz | Licensed Practical Nurse | 8170 Coon Club Rd, Medina, OH 44256 | 2017-09-01 |
| 1942725478 | Amanda Kay Byrne | Registered Nurse | 1000 Concord Dr., Medina, OH 44256 | 2017-08-05 |
| 1821526922 | Melissa Marie Rutti | Nurse Practitioner | 111 Reagan Pkwy, Medina, OH 44256 | 2017-06-01 |
| 1992238919 | Lisa Scherler | Speech-Language Pathologist | 3880 Ridge Rd., Medina, OH 44256 | 2017-04-06 |
| 1770026502 | Victoria Lee Ayala | Speech-Language Pathologist | 390 Fair Street, Berea, OH 44256 | 2016-11-28 |
| 1982076626 | Finding Your Identity LLC | Community/Behavioral Health | 124 West Lafayette Road, Suite 100, Medina, OH 44256 | 2015-10-21 |
| Find all providers in zip 44256 | ||||
| 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 |
|---|---|---|---|---|
| 1548395429 | Salvatore Russell Pecoraro | Emergency Medicine | 200 Ohio Street, Medina Memorial Hospital, Medina, NY 14103 | 2007-02-22 |
| 1043258213 | Michael Edward Ort | Emergency Medicine | 713 Blackmon St, Medina, TN 38355-8839 | 2006-06-02 |
| 1205883899 | Douglas Fall | Emergency Medicine | 4001 Carrick Dr Ste 160, Medina, OH 44256-5392 | 2006-05-28 |
| 1093717522 | Kim D Bowen | Emergency Medicine | 1000 E Washington, Medina General Hospital Ed, Medina, OH 44256 | 2005-08-15 |
| 1174525620 | Medina Emergency Associates Ltd | Emergency Medicine | 1000 E Washing Ave, Medina, OH 44256 | 2005-08-15 |
| 1114358280 | New York Physician Medical Services, Pllc | Emergency Medicine | 200 Ohio St, Medina, NY 14103-1063 | 2013-11-27 |
| 1679901268 | Summa Emergency Associates, Inc. | Emergency Medicine | 3780 Medina Rd, Medina, OH 44256-9311 | 2013-10-17 |
| 1922341411 | Lisa Webb Derrick | Emergency Medicine | 1000 E Washington St, Medina, OH 44256-2170 | 2013-04-03 |
| 1891019576 | Edward S Hawkins | Emergency Medicine | 1000 E Washington St, Medina General Hospital Emergency Dept, Medina, OH 44256-2170 | 2010-03-24 |
| 1942217070 | Lisa Marie Deranek | Emergency Medicine | 1000 E Washington St, Medina, OH 44256-2170 | 2006-08-02 |
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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.