NPIMap

Organization Active NPI

Perioperative Medical Consutants Inc

  • Anesthesiology Physician
  • Fairfield, OH
National Provider Identifier
1124028162
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
PERIOPERATIVE MEDICAL CONSUTANTS INC
Practice address
3000 Mack Rd
Fairfield, OH 45014-5335
Phone
(513) 672-4128
Fax
(513) 672-4479
NPI assigned
Jul 29, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Jeffrey Philip, MDNPI 1124020904
Title
President
Phone
(513) 672-4128

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X OH Primary

Addresses

Primary practice location

3000 Mack Rd
Fairfield, OH 45014-5335

Mailing address

200 Northland Blvd FL 1Sr
Cincinnati, OH 45246-3604
Phone (513) 672-4128

Other identifiers 7

IdentifierTypeStateIssuer
2628222MedicaidOH
2006171MedicaidOH
2202888MedicaidOH
2006180MedicaidOH
2056064MedicaidOH
65943326MedicaidKY
2060148MedicaidOH

National Provider Directory

National Provider Directory

Locations

200 Northland Blvd
Fl 1SR
Cincinnati, OH 45246

2990 Mack Rd
Fairfield, OH 45014
Phone (513) 774-2880

Practitioners & affiliated clinicians

Practitioners 101

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

View all 101

NPI Registry JSON

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

{
    "created_epoch": "1122595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1124028162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 NORTHLAND BLVD FL 1SR",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452463604",
            "telephone_number": "513-672-4128",
            "fax_number": "513-672-4479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 MACK RD",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450145335",
            "telephone_number": "513-672-4128",
            "fax_number": "513-672-4479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERIOPERATIVE MEDICAL CONSUTANTS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-29",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "PHILIP",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "513-672-4128",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2628222",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2006171",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2202888",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2006180",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2056064",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65943326",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2060148",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.