1821039306 NPI number — DR. JOSEPH RICHARD HELLMANN M.D.

Table of content: (NPI 1336778737)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821039306 NPI number — DR. JOSEPH RICHARD HELLMANN M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HELLMANN
Provider First Name:
JOSEPH
Provider Middle Name:
RICHARD
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1821039306
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/17/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
237 WILLIAM HOWARD TAFT, PHYS DIV
Provider Second Line Business Mailing Address:
2ND FL, CBO2-3, ATTN: CREDENTIALING
Provider Business Mailing Address City Name:
CINCINNATI
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45219-2906
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-263-8571
Provider Business Mailing Address Fax Number:
513-366-4480

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7691 5 MILE RD
Provider Second Line Business Practice Location Address:
SUITE 214
Provider Business Practice Location Address City Name:
CINCINNATI
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45230-4348
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-232-3277
Provider Business Practice Location Address Fax Number:
513-232-3444
Provider Enumeration Date:
06/08/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Y00000X , with the licence number:  055687 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 793768 . This is a "ANTHEM" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 0881283 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 270577733076 . This is a "CARESOURCE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 1628296 . This is a "GATEWAY HEALTH" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 201229680 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4229116 . This is a "AETNA" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: P01139508 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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