ERIESIDE MEDICAL GROUP (NPI# 1891751657) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891751657 |
| Entity Type | Organization |
| Organization Name | ERIESIDE MEDICAL GROUP |
| Practice Address |
38429 Lake Shore Blvd Willoughby OH 44094-7009 |
| Practice Telephone | 4409469200 |
| Mailing Telephone | 4409469200 |
| Enumeration Date | 2006-04-21 |
| Last Update Date | 2010-06-10 |
| Authorized Official Name | DR. WINSTON HO (PRESIDENT) |
| Authorized Official Telephone | 4402697483 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 35-06-5285H | OH | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | 34-003413F | OH | Allopathic & Osteopathic Physicians |
| N | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
35-06-1390M | Allopathic & Osteopathic Physicians | |
| Y | 207Q00000X | Family Medicine | 35-052285D | OH | Allopathic & Osteopathic Physicians |
| Street Address |
38429 LAKE SHORE BLVD |
| City | WILLOUGHBY |
| State | OH |
| Zip Code | 44094-7009 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578548962 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 38429 Lake Shore Blvd, Willoughby, OH 44094-7009 | 2005-12-08 |
| 1841674009 | Tawana Cunningham | Nurse Practitioner | 38429 Lake Shore Blvd, Willoughby, OH 44094-7009 | 2015-07-16 |
| 1225318330 | Leah Sopko | Nurse Practitioner | 38429 Lake Shore Blvd, Willoughby, OH 44094-7009 | 2011-08-19 |
| 1194802454 | Winston Ho | Internal Medicine | 38429 Lake Shore Blvd, Willoughby, OH 44094-7009 | 2006-11-01 |
| 1154408490 | James Mandelik | Pediatrics | 38429 Lake Shore Blvd, Willoughby, OH 44094-7009 | 2006-11-01 |
| 1366479693 | Laura Lee Frycklund | Nurse Practitioner | 38429 Lake Shore Blvd, Willoughby, OH 44094-7009 | 2006-06-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518574367 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 36596 Euclid Ave, Willoughby, OH 44094 | 2020-09-25 |
| 1679111322 | Megan King | Nurse Practitioner | 4078 Erie Street, Unit B, Willoughby, OH 44094 | 2019-12-12 |
| 1124661525 | Mind and Body Infusion Therapies, LLC | Clinic/Center | 9264 Chillicothe Rd., Unit #2, Kirtland, OH 44094 | 2019-10-18 |
| 1679125637 | Christina Maria Chandler | Family Medicine | 39021 Signature Circle, Willoughby, OH 44094 | 2019-07-10 |
| 1467920595 | Rachel Curry | Specialist/Technologist | 53400 Euclid Ave., Apt. E-102, Willoughby, OH 44094 | 2018-11-07 |
| 1437649753 | Katie Lauren Greenaway | Registered Nurse | 5103 Robinhood Dr, Willoughby, OH 44094 | 2018-05-11 |
| 1003346131 | Heather Marie Hayes | Licensed Practical Nurse | 38882 Mentor Ave., Willoughby, OH 44094 | 2017-06-12 |
| 1609305028 | Ann Marie Mason | Counselor | 38882 Mentor Avenue, Willoughby, OH 44094 | 2017-06-08 |
| 1285173005 | Mattie Diann Towns-scott | Social Worker | 34950 Chardon Road, Bldg 2, Suite 210, Willoughby Hills, OH 44094 | 2017-02-13 |
| 1447797329 | Therese Benz | General Acute Care Hospital | 96000 Euclid Ave., Willoughby, OH 44094 | 2017-01-30 |
| Find all providers in zip 44094 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679125637 | Christina Maria Chandler | Family Medicine | 39021 Signature Circle, Willoughby, OH 44094 | 2019-07-10 |
| 1649535444 | Maita Louise Jarkewicz | Family Medicine | 4661 Maple St, Willoughby, OH 44094-5730 | 2012-07-08 |
| 1013907989 | Ming Huei Phillip Chiang | Family Medicine | 36001 Euclid Ave, B4, Willoughby, OH 44094-4643 | 2005-10-24 |
| 1629425582 | Signature Health, Inc | Family Medicine | 38882 Mentor Ave, Willoughby, OH 44094-7875 | 2016-05-20 |
| 1114260122 | Tam Pham Mclean | Family Medicine | 5105 Som Center Rd, #106, Willoughby, OH 44094-4203 | 2013-03-28 |
| 1578717427 | Center for Spinecare and Natural Medicine, LLC. | Family Medicine | 34820 Chardon Rd, Willoughby, OH 44094-9103 | 2008-11-05 |
| 1871798801 | M H Phillip Chiang Md Inc | Family Medicine | 36001 Euclid Ave, B 4, Willoughby, OH 44094-4643 | 2007-06-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255948667 | Grace Laszlo | Family Medicine | 2385 Creek View Pl, Grove City, OH 43123-1518 | 2020-09-29 |
| 1396350138 | Kelly Crego-lee | Family Medicine | 321 Neal Rd, Saint Paris, OH 43072-9305 | 2020-09-09 |
| 1669087524 | Deanna Tiffiene Thompson | Family Medicine | 895 Slagle Pl, Galloway, OH 43119-8821 | 2020-09-08 |
| 1982218145 | Kara Day | Family Medicine | 5867 Dantawood Ln, Liberty Twp, OH 45044-1309 | 2020-09-04 |
| 1669086260 | Family Care Plus Clinic LLC | Family Medicine | 4490 Darrow Rd, Stow, OH 44224-1885 | 2020-09-02 |
| 1619580693 | Erica Jayne Mack | Family Medicine | 542 W Mulberry St, Lancaster, OH 43130-2907 | 2020-08-28 |
| 1588277669 | Sarah Elizabeth Ruth Wilcox | Family Medicine | 3146 Grange Hill Pl, Dublin, OH 43017-1794 | 2020-08-28 |
| 1073126314 | Stawa Rajab Blanco | Family Medicine | 4900 Delhi Rd, Cincinnati, OH 45238-5345 | 2020-08-26 |
| 1154933463 | Amanda Taylor Greenrod | Family Medicine | 11010 Gabriella Dr, Parma, OH 44130-1468 | 2020-08-18 |
| 1457962110 | Mt. Eaton Medical Group | Family Medicine | 15988 E Chestnut St, Mt. Eaton, OH 44659 | 2020-08-14 |
| Find all providers with the same taxonomy | ||||
| City | WILLOUGHBY |
| Zip Code | 44094 |
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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.