NPIMap

Organization Active NPI

Dedicated Ohio Holding, LLC

Doing business as Dedicated Senior Medical Center Glencrossing Way

  • Non-Pharmacy Dispensing Site
  • Cincinnati, OH
National Provider Identifier
1215566658
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
Legal business name
DEDICATED OHIO HOLDING, LLC
Doing business as
Dedicated Senior Medical Center Glencrossing Way
Practice address
5050 Glencrossing Way
Cincinnati, OH 45238-3360
Phone
(513) 813-4311
NPI assigned
Apr 7, 2020
Last updated
Oct 31, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
DEDICATED OHIO HOLDING, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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

Authorized official

Name
Mary Chen
Title
Authorized Official
Phone
(305) 831-4722

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X Primary

Addresses

Primary practice location

5050 Glencrossing Way
Cincinnati, OH 45238-3360

Mailing address

1395 NW 167TH St
Miami, FL 33169-5710
Phone (305) 628-6117

Other names 1

  • Dedicated Senior Medical Center Glencrossing Way Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D2188013Dedicated Senior Medical Center5050 Glencrossing Way, Cincinnati, OH 45238Certificate of waiverJul 9, 2028

National Provider Directory

National Provider Directory
Tax ID family
Dedicated Ohio Holding LLC6 organizations share this tax ID, including this one
Part of
Dedicated Ohio Holding LLC

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5050 Glencrossing Way
Cincinnati, OH 45238
Phone (513) 813-4311

Practitioners & affiliated clinicians

Practitioners 12

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": "1586217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730332800000",
    "number": "1215566658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 NW 167TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331695710",
            "telephone_number": "305-628-6117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 GLENCROSSING WAY",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452383360",
            "telephone_number": "513-813-4311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEDICATED OHIO HOLDING, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DEDICATED OHIO HOLDING, LLC",
        "enumeration_date": "2020-04-07",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A",
        "authorized_official_last_name": "CHEN",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "305-831-4722"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dedicated Senior Medical Center Glencrossing Way",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dedicated Senior Medical Center Glencrossing Way",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.