1609915784 NPI number — CHILDREN'S HOSPITAL MEDICAL CENTER

Table of content: (NPI 1609915784)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609915784 NPI number — CHILDREN'S HOSPITAL MEDICAL CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHILDREN'S HOSPITAL MEDICAL CENTER
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:
Provider Other Organization Name Type Code:
6
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:
1609915784
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/05/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3333 BURNET AVENUE
Provider Second Line Business Mailing Address:
MAIL LOCATION 5021
Provider Business Mailing Address City Name:
CINCINNATI
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45229-3026
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-636-4225
Provider Business Mailing Address Fax Number:
513-636-2511

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3333 BURNET AVENUE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CINCINNATI
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45229-3039
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-636-4225
Provider Business Practice Location Address Fax Number:
513-636-2511
Provider Enumeration Date:
02/06/2007

Additional Information

Authorized Official

Authorized Official Last Name:
GIVENS
Authorized Official First Name:
KIMBERLY
Authorized Official Middle Name:
Authorized Official Title or Position:
SR. DIRECTOR MEDICAL STAFF SERVICES
Authorized Official Telephone Number:
513-636-6977

Provider Taxonomy Codes

  • Taxonomy code: 101Y00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103G00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103T00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152WP0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207LP3000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208000000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2251S0007X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225XP0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 231H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 235Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363A00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363L00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 364S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 0001846001 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 001065780-0005 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 117749401 , issued by the state of ( WY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 119659404 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100690580B , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".
  • Identifier: 108749800 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8674809 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 65823524 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0307822 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100280240C , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 77903474 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 78904349 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 95901138 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: QPA814 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 001065780-0006 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0738674 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100012670A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1172363 . This is a "PASSPORT (NEONATAL)" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 02757106 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1172052 . This is a "PASSPORT" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".




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