NPIMap

Organization Active NPI

University Rehabilitation, Inc.

  • Physical Medicine & Rehabilitation Physician
  • Cincinnati, OH
National Provider Identifier
1235197302
Registry record updated Sep 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
UNIVERSITY REHABILITATION, INC.
Practice address
151 W Galbraith Rd
Drake Center
Cincinnati, OH 45216-1015
Phone
(513) 418-2707
Fax
(513) 418-5838
NPI assigned
May 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2010

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

Authorized official

Name
Dr. Mark J. Goddard, M.D.NPI 1184653719
Title
President
Phone
(513) 558-2919

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208100000X Primary
Neurology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2084N0400X
Physician AssistantGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363A00000X 50.000932 OH

Addresses

Primary practice location

151 W Galbraith Rd
Drake Center
Cincinnati, OH 45216-1015

Mailing address

2830 Victory Pkwy
Cincinnati, OH 45206-1785
Phone (513) 245-3617

Other identifiers 13

IdentifierTypeStateIssuer
2529580MedicaidOH
2331015MedicaidOH
2529393MedicaidOH
2548121MedicaidOH
2609672MedicaidOH
65912933MedicaidKY
0626175MedicaidOH
100011480MedicaidIN
2529437MedicaidOH
50005942OtherKYPASSPORT HEALTH PLAN
2330972MedicaidOH
2330981MedicaidOH
2330990MedicaidOH

National Provider Directory

National Provider Directory

Locations

222 Piedmont Ave
Ste 3400
Cincinnati, OH 45219
Phone (513) 558-8686

7700 University Dr
Ste 3600
West Chester, OH 45069
Phone (513) 475-8276

Practitioners & affiliated clinicians

Practitioners 22

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 22

NPI Registry JSON

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285286400000",
    "number": "1235197302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2830 VICTORY PKWY",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452061785",
            "telephone_number": "513-245-3617",
            "fax_number": "513-475-7259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 W GALBRAITH RD",
            "address_2": "DRAKE CENTER",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452161015",
            "telephone_number": "513-418-2707",
            "fax_number": "513-418-5838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY REHABILITATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-01",
        "last_updated": "2010-09-24",
        "status": "A",
        "authorized_official_last_name": "GODDARD",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "513-558-2919",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.000932",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2529580",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2331015",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2529393",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2548121",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2609672",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65912933",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0626175",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100011480",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2529437",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT HEALTH PLAN",
            "identifier": "50005942",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2330972",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2330981",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2330990",
            "state": "OH"
        }
    ],
    "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 24, 2010; 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.