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WOODSIDE MEDICAL GROUP, INC.
NPI 1821148404
Clinic/Center - Medical Specialty in Mansfield, OH

Active since January 12, 2007
475 LEXINGTON AVE, MANSFIELD, OH 44907(419) 756-2003(419) 756-3637 Get Directions Write a Review

NPPES record last updated: October 4, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Woodside Medical Group, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WOODSIDE MEDICAL GROUP, INC. (NPI 1821148404) is a healthcare organization registered as a medical specialty in Mansfield, Ohio and active in the NPI registry since January 2007. The organization lists Robert Edwin Exten, Pres, as its authorized official.

NPPES Registry Identity

NPI1821148404
Entity TypeOrganization
Primary Taxonomy261QM2500X
Legal Business NameWOODSIDE MEDICAL GROUP, INC.
Location Address475 LEXINGTON AVEMansfield, OH 44907-1501
Mailing Address475 Lexington AveMansfield, OH 44907-1501 · (419) 756-2003 · Fax (419) 756-3637
Phone(419) 756-2003
Fax(419) 756-3637
Organization SubpartNo
Authorized OfficialRobert Edwin ExtenPres · (419) 756-2003
Enumeration DateJanuary 12, 2007
Last NPPES UpdateOctober 4, 2011
✔ NPI 1821148404 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Medical SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM2500X
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
Also ListedClinic/Center · Infusion TherapyTaxonomy 261QI0500X
475 LEXINGTON AVE, Mansfield, OH 44907
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Other Identifiers 1

Medicare ID-Type Unspecified9307241Medicare

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SHAUNQUA S CRAWFORD LPN
Licensed Practical Nurse
475 LEXINGTON AVE
MANSFIELD, OH 44907
Richland County (419) 419-5705
ALISSA R KEYSOR LPN
Licensed Practical Nurse
475 LEXINGTON AVE
MANSFIELD, OH 44907
Richland County (419) 419-5705
SARA PALMER BS, QMHS, CDCA
Counselor (Addiction (Substance Use Disorder))
475 LEXINGTON AVE
MANSFIELD, OH 44907
Richland County (419) 419-5705
DENISE GRAY
Nursing Home Administrator
475 LEXINGTON AVE
MANSFIELD, OH 44907
Richland County (419) 419-5705
TINA MARIE SMITH LPN
Licensed Practical Nurse
475 LEXINGTON AVE
MANSFIELD, OH 44907
Richland County (419) 419-5705
TIMOTHY SUTTON MD, MPA, MA, CAS
Preventive Medicine (Addiction Medicine)
475 LEXINGTON AVE
MANSFIELD, OH 44907
Richland County (440) 666-5742
LORRIE L. HEDRICK CDCAII
Counselor (Addiction (Substance Use Disorder))
475 LEXINGTON AVE
MANSFIELD, OH 44907
Richland County (419) 419-5705
MRS. DANIELLE RAY ZORNES CDCA
Counselor (Addiction (Substance Use Disorder))
475 LEXINGTON AVE
MANSFIELD, OH 44907
Richland County (419) 419-5705

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Woodside Medical Group, Inc.'s NPI number?

The NPI number for Woodside Medical Group, Inc. is 1821148404. It was assigned to this organization in the NPPES registry on January 12, 2007.

Where is Woodside Medical Group, Inc. located?

Woodside Medical Group, Inc. is located at 475 Lexington Ave, Mansfield, OH 44907. The listed phone number is (419) 756-2003.

What is Woodside Medical Group, Inc.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Medical Specialty, with taxonomy code 261QM2500X.

When was this NPI record last updated?

The NPPES record for Woodside Medical Group, Inc. was last updated on October 4, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.