Organization Active NPI

Jennifer B Manders MD LLC

  • Surgery Physician
  • Cincinnati, OH
National Provider Identifier
1215111539
Registry record updated Apr 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
35-086334 Issued in OH
Legal business name
JENNIFER B MANDERS MD LLC
Practice address
4460 Red Bank Rd
Suite 120
Cincinnati, OH 45227-2172
Phone
(513) 272-1999
NPI assigned
Dec 21, 2007
Last updated
Apr 28, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2009

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

Authorized official

Name
Dr. Jennifer B. Manders, M.D.
Title
Medical Doctor
Phone
(513) 272-1999

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 35-086334 OH Primary

Addresses

Primary practice location

4460 Red Bank Rd
Suite 120
Cincinnati, OH 45227-2172

Mailing address

4460 Red Bank Rd
Suite 120
Cincinnati, OH 45227-2172
Phone (513) 272-1999

Other identifiers 1

IdentifierTypeStateIssuer
200932170AMedicaidIN

National Provider Directory

National Provider Directory

Locations

4460 Red Bank Rd
Ste 120
Cincinnati, OH 45227
Phone (513) 272-1999

Practitioners & affiliated clinicians

Practitioners 1

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": "1198195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240876800000",
    "number": "1215111539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4460 RED BANK RD",
            "address_2": "SUITE 120",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452272172",
            "telephone_number": "513-272-1999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4460 RED BANK RD",
            "address_2": "SUITE 120",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452272172",
            "telephone_number": "513-272-1999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNIFER B MANDERS MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-21",
        "last_updated": "2009-04-28",
        "status": "A",
        "authorized_official_last_name": "MANDERS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "513-272-1999",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "35-086334",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200932170A",
            "state": "IN"
        }
    ],
    "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 Apr 28, 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.