NPIMap

Organization Active NPI

Deaconess Healthcare Services Co

  • Internal Medicine Physician
  • Cincinnati, OH
National Provider Identifier
1194703173
Registry record updated May 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
DEACONESS HEALTHCARE SERVICES CO
Practice address
311 Straight St
Cincinnati, OH 45219-1018
Phone
(513) 557-3330
Fax
(513) 557-3347
NPI assigned
Jan 9, 2006
Last updated
May 12, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2009

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

Authorized official

Name
Kelly Bernens
Title
Business Manager Physician Services
Phone
(513) 559-2891

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

311 Straight St
Cincinnati, OH 45219-1018

Mailing address

PO Box 632745
Cincinnati, OH 45263-2745
Phone (513) 557-3330

Other identifiers 3

IdentifierTypeStateIssuer
200363350BMedicaidIN
0281172MedicaidOH
65935637MedicaidKY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 52

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 52

NPI Registry JSON

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

{
    "created_epoch": "1136764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242086400000",
    "number": "1194703173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 632745",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452632745",
            "telephone_number": "513-557-3330",
            "fax_number": "513-557-3347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 STRAIGHT ST",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452191018",
            "telephone_number": "513-557-3330",
            "fax_number": "513-557-3347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEACONESS HEALTHCARE SERVICES CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-09",
        "last_updated": "2009-05-12",
        "status": "A",
        "authorized_official_last_name": "BERNENS",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "BUSINESS MANAGER PHYSICIAN SERVICES",
        "authorized_official_telephone_number": "513-559-2891"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200363350B",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0281172",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65935637",
            "state": "KY"
        }
    ],
    "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 12, 2009; 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.