Organization Active NPI

Dermatology Associates of Cinti Inc

  • Dermatology Physician
  • Cincinnati, OH
National Provider Identifier
1033240247
Registry record updated Sep 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
DERMATOLOGY ASSOCIATES OF CINTI INC
Practice address
10506 Montgomery Road
#402
Cincinnati, OH 45242
Phone
(513) 791-6161
Fax
(513) 791-4004
NPI assigned
Mar 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2011

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

Authorized official

Name
Paul A Lucky, MD
Title
President
Phone
(513) 791-6161

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

10506 Montgomery Road
#402
Cincinnati, OH 45242

Mailing address

10700 Montgomery Road
#207
Cincinnati, OH 45242
Phone (513) 247-9986

Other identifiers 1

IdentifierTypeStateIssuer
0696493MedicaidOH

National Provider Directory

National Provider Directory

Locations

2123 Auburn Ave
#210
Cincinnati, OH 45219
Phone (513) 579-9191

7691 5 Mile Rd
Ste 312
Cincinnati, OH 45230
Phone (513) 232-3332

10506 Montgomery Rd
Ste 402
Montgomery, OH 45242
Phone (513) 791-6161

10700 Montgomery Rd
Ste 207
Montgomery, OH 45242

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316044800000",
    "number": "1033240247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10700 MONTGOMERY ROAD",
            "address_2": "#207",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "45242",
            "telephone_number": "513-247-9986",
            "fax_number": "513-247-9987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10506 MONTGOMERY ROAD",
            "address_2": "#402",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "45242",
            "telephone_number": "513-791-6161",
            "fax_number": "513-791-4004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY ASSOCIATES OF CINTI INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2011-09-15",
        "status": "A",
        "authorized_official_last_name": "LUCKY",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "513-791-6161",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0696493",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2011; 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.