1801081476 NPI number — ORTHOPAEDIC CONSULTANTS OF CINCINNATI, INC.

Table of content: (NPI 1801081476)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801081476 NPI number — ORTHOPAEDIC CONSULTANTS OF CINCINNATI, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ORTHOPAEDIC CONSULTANTS OF CINCINNATI, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
WELLINGTON ORTHOPAEDIC AND SPORTS MEDICINE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1801081476
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/01/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4701 CREEK RD
Provider Second Line Business Mailing Address:
SUITE 110
Provider Business Mailing Address City Name:
CINCINNATI
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45242-8398
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-618-9011
Provider Business Mailing Address Fax Number:
513-588-2479

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
30 E APPLE ST
Provider Second Line Business Practice Location Address:
MVH, SUITE 2200
Provider Business Practice Location Address City Name:
DAYTON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45409-2939
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
937-208-2091
Provider Business Practice Location Address Fax Number:
937-208-6141
Provider Enumeration Date:
09/07/2007

Additional Information

Authorized Official

Authorized Official Last Name:
PLETTNER
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
P
Authorized Official Title or Position:
OWNER/PARTNER
Authorized Official Telephone Number:
513-618-9011

Provider Taxonomy Codes

  • Taxonomy code: 207X00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 335E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: CB4566 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 0494719 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2796167 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




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