Organization Active NPI

Ohio Phlebology Professional Corporation

  • Phlebology Physician
  • Cincinnati, OH
National Provider Identifier
1205090347
Registry record updated Sep 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Phlebology PhysicianTaxonomy code 202K00000X
Legal business name
OHIO PHLEBOLOGY PROFESSIONAL CORPORATION
Practice address
8044 Montgomery Rd
Suite 525
Cincinnati, OH 45236-2919
Phone
(630) 725-2768
NPI assigned
Jul 17, 2008
Last updated
Sep 4, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2025

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

Authorized official

Name
Tara Bland
Title
Manager
Phone
(513) 793-7999

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X OH
Surgery Physician 208600000X OH
Vascular Surgery Physician 2086S0129X OH
Phlebology Physician 202K00000X OH Primary

Addresses

Primary practice location

8044 Montgomery Rd
Suite 525
Cincinnati, OH 45236-2919

Mailing address

8044 Montgomery Rd Ste 525
Cincinnati, OH 45236-2925
Phone (513) 793-7999

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090225000016 OH Part B Supplier - Clinic/Group Practice 3870658958 Receives reassigned benefits from 2 practitioners
Practice locations: Cincinnati, OH

National Provider Directory

National Provider Directory

Locations

2055 Crocker Rd
Ste 207
Westlake, OH 44145
Phone (440) 835-5555

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1216252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756944000000",
    "number": "1205090347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8044 MONTGOMERY RD STE 525",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452362925",
            "telephone_number": "513-793-7999",
            "fax_number": "513-802-5054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8044 MONTGOMERY RD",
            "address_2": "SUITE 525",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452362919",
            "telephone_number": "630-725-2768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OHIO PHLEBOLOGY PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-17",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A",
        "authorized_official_last_name": "BLAND",
        "authorized_official_first_name": "TARA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "513-793-7999"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "202K00000X",
            "taxonomy_group": "",
            "desc": "Phlebology",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Sep 4, 2025; 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.