Individual provider Active NPI

Kevin Michael Overmann

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Cincinnati, OH
National Provider Identifier
1033400387
Registry record updated Dec 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
35.123071 Issued in OH
Practice address
3333 Burnet Ave
ML 2008
Cincinnati, OH 45229-3026
Phone
(513) 636-7966
Fax
(513) 636-7967
NPI assigned
Apr 20, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 35.123071 OH
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 35.123071 OH Primary

Addresses

Primary practice location

3333 Burnet Ave
ML 2008
Cincinnati, OH 45229-3026

Mailing address

3333 Burnet Ave
ML 2008
Cincinnati, OH 45229-3026
Phone (513) 636-7966

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140529000674 OH Practitioner - Pediatric Medicine 4486877057 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Ohio State University College of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3333 Burnet Ave
Cincinnati, OH 45229-3026
Phone (513) 636-4200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Hospital Medical Center Pediatrics CurrentSince Mar 11, 2016 Accepting new patients
Nationwide Children's Hospital Past Accepting new patients

Locations

3341 Solutions Ctr
Chicago, IL 60677

3333 Burnet Ave
#2008
Cincinnati, OH 45229
Phone (513) 636-7966

3333 Burnet Ave
#5021
Cincinnati, OH 45229
Phone (513) 636-4225

3333 Burnet Ave
Cincinnati, OH 45229
Phone (513) 636-4200

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1303257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575244800000",
    "number": "1033400387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVE",
            "address_2": "ML 2008",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293026",
            "telephone_number": "513-636-7966",
            "fax_number": "513-636-7967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVE",
            "address_2": "ML 2008",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293026",
            "telephone_number": "513-636-7966",
            "fax_number": "513-636-7967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OVERMANN",
        "first_name": "KEVIN",
        "middle_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-20",
        "last_updated": "2019-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35.123071",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "OH",
            "license": "35.123071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.