Individual provider Active NPI

Nan Lin, M.D.

  • Neurology with Special Qualifications in Child Neurology Physician
  • Cincinnati, OH
National Provider Identifier
1104189463
Registry record updated Jul 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
35.130830 Issued in OH
Practice address
3333 Burnet Ave Ml11006
Cincinnati, OH 45229-3026
Phone
(513) 636-4991
Fax
(513) 636-3980
NPI assigned
Jun 21, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2018

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 MT201996 PA
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 35.130830 OH Primary

Addresses

Primary practice location

3333 Burnet Ave Ml11006
Cincinnati, OH 45229-3026

Mailing address

3333 Burnet Ave Ml11006
Cincinnati, OH 45229-3026
Phone (513) 636-4991

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180918004338 OH Practitioner - Neurology 2264783026 Reassigns benefits to 1 organization
I20181019002542 IL Practitioner - Pediatric Medicine 2264783026 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
University of Minnesota Medical School, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Children'S Hospital Medical CenterGroup PAC ID 8426955733, 716 clinicians

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

State licenses

LicenseStateTypeSpecialty
MT201996PAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cook County Current Accepting new patients
Cook County Pediatrics CurrentSince Dec 14, 2018 Accepting new patients
Cook County CurrentSince Dec 14, 2018 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Children'S Hospital Medical Center Past Accepting new patients

Locations

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

Interoperability endpoints

  • Direct secure messaging: nlin206040@direct.uchealth.com

Organizations & group practices 6

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": "1340236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531353600000",
    "number": "1104189463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVE ML11006",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293026",
            "telephone_number": "513-636-4991",
            "fax_number": "513-636-3980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVE ML11006",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293026",
            "telephone_number": "513-636-4991",
            "fax_number": "513-636-3980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIN",
        "first_name": "NAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-21",
        "last_updated": "2018-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MT201996",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "OH",
            "license": "35.130830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.