Cincinnati Pet Scan, LLC

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

License

730088 Issued in KY

Legal business name

CINCINNATI PET SCAN, LLC

Practice address

651 Centre View Blvd
110
Crestview Hills, KY 41017-5423

Phone

(859) 547-1240

Fax

(859) 547-1245

NPI assigned

Nov 1, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. John Mattes

Title

President

Phone

(513) 791-9959

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Cincinnati Pet Scan LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Cincinnati Pet Scan, LLC

  • Radiology Clinic/Center
  • Cincinnati, OH
  • NPI 1063525582
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023195088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "651 CENTRE VIEW BLVD",
            "address_2": "110",
            "city": "CRESTVIEW HILLS",
            "state": "KY",
            "postal_code": "410175423",
            "telephone_number": "859-547-1240",
            "fax_number": "859-547-1245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 CENTRE VIEW BLVD",
            "address_2": "110",
            "city": "CRESTVIEW HILLS",
            "state": "KY",
            "postal_code": "410175423",
            "telephone_number": "859-547-1240",
            "fax_number": "859-547-1245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CINCINNATI PET SCAN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MATTES",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "513-791-9959",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "KY",
            "license": "730088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "86000437",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cincinnati Healthcare Group PSC, Dba Patient First Physicians Group
• Cincinnati Healthcare Group PSC, Dba Patient First Physicians Group
• Cincinnati Healthcare Group PSC, Dba Patient First Physicians Group
• Cincinnati Healthcare Group PSC, Dba Patient First Physicians Group
• Cincinnati Hematology-Oncology, Inc
• Cincinnati Sportsmedicine and Orthopaedic Center, Inc.
• Christopher Cirulli, MD
• Shannon D. Clifton, OT
• Benjamin Cole
• Christopher Lee Colglazier, MD

• Radiology Clinic/Center in Crestview Hills, KY
• Providers in Crestview Hills, KY by specialty
• Radiology Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.