Organization Active NPI

Western Hills Interventional Pain LLC

  • Physical Medicine & Rehabilitation Physician
  • Cincinnati, OH
National Provider Identifier
1134416886
Registry record updated May 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
35084990 Issued in OH
Legal business name
WESTERN HILLS INTERVENTIONAL PAIN LLC
Practice address
3860 Race Rd Ste 203
Cincinnati, OH 45211-4307
Phone
(513) 842-7781
Fax
(513) 842-7783
NPI assigned
Jul 1, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2018

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

Authorized official

Name
Sung Ki Min, MDNPI 1114978012
Title
MD/Owner
Phone
(513) 842-7781

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208100000X 35084990 OH Primary
Interventional Pain Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208VP0014X 35084990 OH

Addresses

Primary practice location

3860 Race Rd Ste 203
Cincinnati, OH 45211-4307

Mailing address

6460 Harrison Ave
Suite 300
Cincinnati, OH 45247-7957
Phone (513) 842-7781

Other identifiers 2

IdentifierTypeStateIssuer
201047290MedicaidIN
0056085MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110809000590 OH Part B Supplier - Clinic/Group Practice 5991974925 Receives reassigned benefits from 1 practitioner
Practice locations: Cincinnati, OH

National Provider Directory

National Provider Directory

Locations

6460 Harrison Ave
Ste 300
Cincinnati, OH 45247
Phone (513) 842-7781

3860 Race Rd
Ste 203
Cincinnati, OH 45211
Phone (513) 842-7781

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1309478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525132800000",
    "number": "1134416886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6460 HARRISON AVE",
            "address_2": "SUITE 300",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452477957",
            "telephone_number": "513-842-7781",
            "fax_number": "513-842-7783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3860 RACE RD STE 203",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452114307",
            "telephone_number": "513-842-7781",
            "fax_number": "513-842-7783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN HILLS INTERVENTIONAL PAIN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-01",
        "last_updated": "2018-05-01",
        "status": "A",
        "authorized_official_last_name": "MIN",
        "authorized_official_first_name": "SUNG",
        "authorized_official_middle_name": "KI",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "513-842-7781",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "OH",
            "license": "35084990",
            "primary": true
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "OH",
            "license": "35084990",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201047290",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0056085",
            "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 May 1, 2018; 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.