Eastern Cincinnati Internal Medicine Specialist,LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

EASTERN CINCINNATI INTERNAL MEDICINE SPECIALIST,LLC

Practice address

4044 McLean Dr
Cincinnati, OH 45255-3323

Phone

(513) 528-3300

Fax

(513) 528-9023

NPI assigned

Oct 16, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Edward J Severyn, M.D.

Title

Owner

Phone

(513) 528-3300

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194393600000",
    "number": "1033209242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4044 MCLEAN DR",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452553323",
            "telephone_number": "513-528-3300",
            "fax_number": "513-528-9023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4044 MCLEAN DR",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452553323",
            "telephone_number": "513-528-3300",
            "fax_number": "513-528-9023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN CINCINNATI INTERNAL MEDICINE SPECIALIST,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-16",
        "last_updated": "2007-11-07",
        "status": "A",
        "authorized_official_last_name": "SEVERYN",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "513-528-3300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Internal Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2007; 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.