NPIMap

Organization Active NPI

Plastic Surgery Group Inc

  • Specialist
  • Cincinnati, OH
National Provider Identifier
1083737027
Registry record updated Nov 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
PLASTIC SURGERY GROUP INC
Practice address
4030 Smith Road
Suite 350
Cincinnati, OH 45209-1969
Phone
(513) 791-4440
Fax
(513) 985-6615
NPI assigned
Apr 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2022

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

Authorized official

Name
Mrs. Stephanie Wethington
Title
Practice Administator
Phone
(513) 349-5512

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

4030 Smith Road
Suite 350
Cincinnati, OH 45209-1969

Mailing address

4030 Smith Road
Suite 350
Cincinnati, OH 45209-1969
Phone (513) 791-4440

Other practice location 1

4850 Red Bank Rd
Cincinnati, OH 45227-1545
Phone (513) 791-4440

Other identifiers 1

IdentifierTypeStateIssuer
0167877MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20041109001164 KY Part B Supplier - Clinic/Group Practice 9133182223 Receives reassigned benefits from 3 practitioners
Practice locations: West Chester, OH
O20050919000746 OH Part B Supplier - Clinic/Group Practice 9133182223 Receives reassigned benefits from 6 practitioners
Practice locations: West Chester, OH; Cincinnati, OH

National Provider Directory

National Provider Directory
Tax ID family
The Plastic Surgery Group3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

340 Thomas More Pkwy
Ste 100
Crestview Hills, KY 41017
Phone (513) 791-4440

4850 Red Bank Rd
Fl 1
Cincinnati, OH 45227
Phone (513) 791-4440

7162 Liberty Centre Dr
Unit C
West Chester, OH 45069
Phone (513) 769-3223

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669680000000",
    "number": "1083737027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4030 SMITH ROAD",
            "address_2": "SUITE 350",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452091969",
            "telephone_number": "513-791-4440",
            "fax_number": "513-985-6615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4030 SMITH ROAD",
            "address_2": "SUITE 350",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452091969",
            "telephone_number": "513-791-4440",
            "fax_number": "513-985-6615"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4850 Red Bank Rd",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452271545",
            "country_code": "US",
            "telephone_number": "513-791-4440",
            "fax_number": "513-985-6615",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PLASTIC SURGERY GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-06",
        "last_updated": "2022-11-29",
        "certification_date": "2022-11-29",
        "status": "A",
        "authorized_official_last_name": "WETHINGTON",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "PRACTICE ADMINISTATOR",
        "authorized_official_telephone_number": "513-349-5512",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0167877",
            "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 Nov 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.