WESTERN RESERVE PROFESSIONAL GROUP INC NPI 1699986620

NPI Information

NPI: 1699986620
Provider Name: WESTERN RESERVE PROFESSIONAL GROUP INC

Doing Business As: THE SPINE & PAIN INSTITUTE

Classification: Physical Medicine & Rehabilitation - 2081P2900X
Entity Type: Organization

Specialization: Pain Medicine

Address:
307 WEST MAIN STREET
SUITE C
KENT, OH
ZIP 44240
Phone: (330) 677-3628
Get Directions

WESTERN RESERVE PROFESSIONAL GROUP INC is a pain medicine physical medicine rehabilitation in Kent, OH. The provider is a physician 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. WESTERN RESERVE PROFESSIONAL GROUP INC NPI is 1699986620. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As The Spine & Pain Institute.

The provider's business location address is:

307 WEST MAIN STREET
SUITE C
KENT, OH
ZIP 44240-400
Phone: (330) 677-3628
Fax: (330) 677-4931

The provider's authorized official is Rachelle Ann Light .
The authorized official title is Office Coordinator and has the following contact phone number (330) 677-3628.

The enumeration date for this NPI number is 5/24/2007 and was last updated on 1/15/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	111NX0800X	Chiropractor	Orthopedic	No
2	208100000X	Physical Medicine & Rehabilitation		No
3	208VP0014X	Pain Medicine	Interventional Pain Medicine	No
4	225100000X	Physical Therapist		No
5	2081P2900X	Physical Medicine & Rehabilitation	Pain Medicine	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	0251070	MEDICAID	OHIO
2	4086482	MEDICARE PIN	OHIO
3	12991	MEDICARE PIN	OHIO
4	2553151	MEDICARE PIN	OHIO
5	4133101	MEDICARE PIN	OHIO
6	2311331	MEDICAID	OHIO
7	0926887	MEDICAID	OHIO
8	4085673	MEDICAID	OHIO
9	2675921	MEDICAID	OHIO
10	2406275	MEDICAID	OHIO
11	4085673	MEDICARE PIN	OHIO
12	4066829	MEDICARE PIN	OHIO
13	4169412	MEDICARE PIN	OHIO
14	2493038	MEDICAID	OHIO
15	2082866	MEDICAID	OHIO
16	4720180001	MEDICARE NSC	OHIO
17	9283485	MEDICARE PIN	OHIO
18	4148851	MEDICARE PIN	OHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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