1982701405 NPI number — ROBERT REED MD

Table of content: ROBERT REED MD (NPI 1982701405)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982701405 NPI number — ROBERT REED MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
REED
Provider First Name:
ROBERT
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1982701405
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/28/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4685 FOREST AVE
Provider Second Line Business Mailing Address:
STE C
Provider Business Mailing Address City Name:
CINCINNATI
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45212-3359
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-961-5558
Provider Business Mailing Address Fax Number:
513-961-1912

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
111 WELLINGTON PLACE
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:
45219
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-241-2370
Provider Business Practice Location Address Fax Number:
513-241-6053
Provider Enumeration Date:
09/19/2006

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: 2084N0400X , with the licence number:  35-029384 , 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: 000000019347 . This is a "ANTHEM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 05-20165 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 200070290A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 64737422 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 646988 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1943389-001 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 13783 . This is a "NATIONWIDE HEALTH PLANS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 311412447059 . This is a "CARESOURCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0257967 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




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