Karen Agnew, M.D.
Individual provider Active NPI Pediatrics Physician · Mason, OH
NPI 1164735569 · NPPES record last updated Mar 5, 2019
Key facts
- NPI
- 1164735569
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 35.120553 (OH)
- Practice address
- 9600 Children Dr
BLDG D, Suite 100
Mason, OH 45040-6791 - Phone
- (513) 336-6700
- NPI assigned
- Jul 14, 2010
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230209002837 | OH | Practitioner - Pediatric Medicine | 2860864386 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35.120553 | OH | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CHMC Community Health Services Network | Pediatrics | Current |
Accepting new patients |
| CHMC Community Health Services Network | Pediatrics | Current |
Accepting new patients |
| CHMC Community Health Services Network | Pediatrics | Past | Accepting new patients |
Locations
3341 Solutions Ctr
Chicago, IL 60677
7502 State Rd
Ste 3350
Cincinnati, OH 45255
Phone (513) 231-3345
3333 Burnet Ave
#5021
Cincinnati, OH 45229
Phone (513) 636-4225
7335 Yankee Rd
Ste 100
Liberty Township, OH 45044
10554 Loveland Madeira Rd
Loveland, OH 45140
Phone (513) 683-0400
9600 Children Dr
Bldg D
Mason, OH 45040
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/FmRItZc30RH60LjxwsIxQM4HGo6XcQXK/
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 35.120553 | OH | Yes |
Addresses
Primary practice location
9600 Children Dr
BLDG D, Suite 100
Mason, OH 45040-6791
Mailing address
9600 Children Dr
BLDG D, Suite 100
Mason, OH 45040-6791
Phone (513) 336-6700
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0090016 | Medicaid | OH |
Other providers in Mason, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 5, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.