WESTERN RESERVE PROFESSIONAL GROUP (NPI# 1912094145) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912094145 |
| Entity Type | Organization |
| Organization Name | WESTERN RESERVE PROFESSIONAL GROUP |
| Practice Address |
6847 N Chestnut St Ravenna OH 44266-3929 |
| Mailing Address |
307 W Main St Suite C Kent OH 44240-2400 |
| Practice Telephone | 3306773628 |
| Practice Fax Number | 3306773626 |
| Mailing Telephone | 3306773628 |
| Mailing Fax Number | 3306773626 |
| Enumeration Date | 2006-10-09 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | KELLY SEMANCIK (ADMINISTRATIVE DIRECTOR) |
| Authorized Official Telephone | 3306773628 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P2900X |
Psychiatry & Neurology Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780768820 | Western Reserve Professional Group | Physical Medicine & Rehabilitation | 401 Devon Pl, Kent, OH 44240-6482 | 2006-10-25 |
| 1588745632 | Western Reserve Professional Group | Physical Medicine & Rehabilitation | 5700 Darrow Road, Suite 109, Kent, OH 44240 | 2006-10-17 |
| Street Address |
6847 N CHESTNUT ST |
| City | RAVENNA |
| State | OH |
| Zip Code | 44266-3929 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720078306 | Stephanie J Teodosio | Occupational Therapist | 6847 N Chestnut St, Suite 100, Ravenna, OH 44266-3929 | 2005-10-25 |
| 1356949010 | Kimberly Sue Neubig | Licensed Practical Nurse | 6847 N Chestnut St, Ravenna, OH 44266-3929 | 2020-10-15 |
| 1467059956 | Korena L Mulloy | Licensed Practical Nurse | 6847 N Chestnut St, Ravenna, OH 44266-3929 | 2020-10-07 |
| 1104439553 | Temitope A Adeleke | Nurse Practitioner | 6847 N Chestnut St, Ravenna, OH 44266-3929 | 2020-08-26 |
| 1811505175 | Lindsay Hall | Pharmacist | 6847 N Chestnut St, Ravenna, OH 44266-3929 | 2020-07-22 |
| 1568089175 | James Ferrell | Pharmacist | 6847 N Chestnut St, Ravenna, OH 44266-3929 | 2020-06-30 |
| 1437774544 | Glen Robert Williams Jr. | Registered Nurse | 6847 N Chestnut St, Ravenna, OH 44266-3929 | 2020-06-15 |
| 1497379408 | Lauren R Lewis | Nurse Practitioner | 6847 N Chestnut St, Ravenna, OH 44266-3929 | 2020-06-04 |
| 1780208140 | Alexis Hughley | Licensed Practical Nurse | 6847 N Chestnut St, Ravenna, OH 44266-3929 | 2020-06-02 |
| 1811511488 | Carrie Reedy | Licensed Practical Nurse | 6847 N Chestnut St, Ravenna, OH 44266-3929 | 2020-05-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407409501 | Jeffrey Michael Jones | Hearing Instrument Specialist | 131 E. Hain St Beltone Hearing Care Center, Ravenna, OH 44266 | 2019-07-18 |
| 1285286443 | Robert Ailes Lax | Counselor | 246 S. Chestnut St., Ravenna, OH 44266 | 2019-07-09 |
| 1841792314 | Jason Troyer | Case Manager/Care Coordinator | 3920 Lover's Lane, Ravenna, OH 44266 | 2018-03-01 |
| 1316446370 | Jacquelin Grace Claren | Case Manager/Care Coordinator | 3920 Lovers Lane, Ravenna, OH 44266 | 2018-02-06 |
| 1164921318 | Tammy M Morris | Counselor | 4771 Washington Ave., Ravenna, OH 44266 | 2018-02-02 |
| 1306360219 | Megan Kathryn Marsh | Nurse Practitioner | 3215 Menough Rd, Ravenna, OH 44266 | 2017-08-01 |
| 1063875110 | Mary Kathryn Revello | Home Health Aide | 103 N.scycamore St, Ravenna 44266, OH 44266 | 2016-04-05 |
| 1396114302 | Theresa Brooks Kotlar | Registered Nurse | 7174 Colonial Place, Ravenna, OH 44266 | 2015-09-20 |
| 1811384118 | Okap Kwon Md Inc | Internal Medicine | 964 East Main Street, Ravenna, OH 44266 | 2015-04-24 |
| 1104223783 | Julie Winkler | Speech-Language Pathologist | 639 W. Main St, Ravenna, OH 44266 | 2014-11-26 |
| Find all providers in zip 44266 | ||||
| Taxonomy Code | 2084P2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Pain Medicine |
| A neurologist, child neurologists or psychiatrist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Psychiatry and Neurology, 2007. http://www.abpn.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Psychiatry and Neurology. A subspecialty certificate was approved by ABMS in 1998. ACGME Accredited Residency Program Requirements: None. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144835893 | Premier Pharmaceutical Solutions | Psychiatry & Neurology | 7973 Truman Trl, Reynoldsburg, OH 43068-9315 | 2020-09-10 |
| 1487170205 | William Ward Bedilion | Psychiatry & Neurology | 200 Stanley Mills Rd, Little Hocking, OH 45742 | 2017-08-15 |
| 1003940032 | Walter G Broadnax | Psychiatry & Neurology | 5505 Fair Ln, Cincinnati, OH 45227-3401 | 2007-03-14 |
| 1134135882 | Ashraf S Nassef Md Inc | Psychiatry & Neurology | 4404 Glen Este Withamsville Rd, Cincinnati, OH 45245-1306 | 2006-08-01 |
| 1275964934 | Mana Medical, Inc. | Psychiatry & Neurology | 880 Greenlawn Ave, Columbus, OH 43223-2616 | 2013-12-06 |
| 1942545546 | Amr LLC | Psychiatry & Neurology | 6096 E Main St Ste 103, Columbus, OH 43213-4302 | 2012-12-07 |
| 1851608087 | Industrial Health Consultants | Psychiatry & Neurology | 5660 Monroe St, Suite 7, Sylvania, OH 43560-2733 | 2010-09-09 |
| 1427160944 | Onassis A Caneris | Psychiatry & Neurology | 4805 Montgomery Rd, Suite 210, Cincinnati, OH 45212-2198 | 2006-08-31 |
| 1962437947 | Lutheran Hospital | Psychiatry & Neurology | 1730 W 25th St, Cleveland, OH 44113-3108 | 2006-07-11 |
| 1689606295 | Sarah Elizabeth Blake | Psychiatry & Neurology | 3600 Olentangy River Rd, Bldg 480, Columbus, OH 43214-3437 | 2006-07-06 |
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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.