NPIMap

Organization Active NPI

Bethesda Family Practice Center

  • Family Medicine Physician
  • Cincinnati, OH
National Provider Identifier
1124061494
Registry record updated Mar 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
BETHESDA FAMILY PRACTICE CENTER
Practice address
1775 W Lexington Ste 100
Cincinnati, OH 45212-3667
Phone
(513) 977-6700
Fax
(513) 531-2624
NPI assigned
Jun 14, 2006
Last updated
Mar 27, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2018

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

Authorized official

Name
Linda Estep
Title
Manager
Phone
(513) 977-6715

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

1775 W Lexington Ste 100
Cincinnati, OH 45212-3667

Mailing address

1775 W Lexington Ste 100
Cincinnati, OH 45212-3667
Phone (513) 977-6700

Other identifiers 1

IdentifierTypeStateIssuer
0687529MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040505000929 OH Part B Supplier - Clinic/Group Practice 7012905292 Receives reassigned benefits from 26 practitioners
Practice locations: Cincinnati, OH

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D0676993Bethesda Family Practice1775 W Lexington Avenue, Suite 100, Cincinnati, OH 45212Certificate of waiverJul 7, 2027

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1775 W Lexington
Ste 100
Cincinnati, OH 45212
Phone (513) 531-6720

Practitioners & affiliated clinicians

Practitioners 93

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.

View all 93

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522108800000",
    "number": "1124061494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1775 W LEXINGTON STE 100",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452123667",
            "telephone_number": "513-977-6700",
            "fax_number": "513-531-2624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 W LEXINGTON STE 100",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452123667",
            "telephone_number": "513-977-6700",
            "fax_number": "513-531-2624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHESDA FAMILY PRACTICE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-14",
        "last_updated": "2018-03-27",
        "status": "A",
        "authorized_official_last_name": "ESTEP",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "513-977-6715"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0687529",
            "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 Mar 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.