Active NPI
Southern Ohio Recovery Group, Inc
- Addiction Medicine (Family Medicine) Physician
- Blue Ash, OH
National Provider Identifier
1043739196
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction Medicine (Family Medicine) Physician
- Legal business name
- SOUTHERN OHIO RECOVERY GROUP, INC
- Practice address
- 9403 Kenwood Rd
Blue Ash, OH 45242-6895 - Phone
- (513) 543-6600
- NPI assigned
- Sep 10, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Rachele Smith
- Title
- Practice Manager
- Phone
- (513) 377-9374
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction Medicine (Family Medicine) Physician | 207QA0401X | Primary |
Addresses
Primary practice location
9403 Kenwood Rd
Blue Ash, OH 45242-6895
Mailing address
9403 Kenwood Rd
Blue Ash, OH 45242-6895
Phone (513) 543-6600
Other practice location 1
1592 Goodman Ave
Cincinnati, OH 45224-1005
Phone (513) 522-7246
Other practice location 2
950 E Alex Bell Rd # Ll
Centerville, OH 45459-2721
Phone (937) 291-2300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 31094333 | Medicaid | OH |
National Provider Directory
National Provider DirectoryLocations
1592 Goodman Ave
Cincinnati, OH 45224
Phone (513) 522-7246
Practitioners & affiliated clinicians
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Case Manager/Care Coordinator
- Centerville, OH
- NPI 1811521743
-
- Case Manager/Care Coordinator
- Centerville, OH
- NPI 1013540418
-
- Case Management Agency
- Dayton, OH
- NPI 1679166631
-
- Addiction (Substance Use Disorder) Counselor
- Dayton, OH
- NPI 1528663994
-
- Counselor
- Trenton, OH
- NPI 1376166249
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1505001600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1521244800000",
"number": "1043739196",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9403 KENWOOD RD",
"city": "BLUE ASH",
"state": "OH",
"postal_code": "452426895",
"telephone_number": "513-543-6600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9403 KENWOOD RD",
"city": "BLUE ASH",
"state": "OH",
"postal_code": "452426895",
"telephone_number": "513-543-6600"
}
],
"practiceLocations": [
{
"address_1": "1592 Goodman Ave",
"address_purpose": "LOCATION",
"city": "Cincinnati",
"state": "OH",
"postal_code": "452241005",
"country_code": "US",
"telephone_number": "513-522-7246",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "950 E Alex Bell Rd # Ll",
"address_purpose": "LOCATION",
"city": "Centerville",
"state": "OH",
"postal_code": "454592721",
"country_code": "US",
"telephone_number": "937-291-2300",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "SOUTHERN OHIO RECOVERY GROUP, INC",
"organizational_subpart": "NO",
"enumeration_date": "2017-09-10",
"last_updated": "2018-03-17",
"status": "A",
"authorized_official_last_name": "SMITH",
"authorized_official_first_name": "RACHELE",
"authorized_official_title_or_position": "PRACTICE MANAGER",
"authorized_official_telephone_number": "513-377-9374"
},
"taxonomies": [
{
"code": "207QA0401X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine, Addiction Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "31094333",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Blue Ash, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.