Organization Active NPI

City of Cincinnati

  • Community Health Clinic/Center
  • Cincinnati, OH
National Provider Identifier
1275689671
Registry record updated Jun 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
Legal business name
CITY OF CINCINNATI
Practice address
2750 Beekman St
Cincinnati, OH 45225-2049
Phone
(513) 352-3192
Fax
(513) 352-3137
NPI assigned
Jan 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2010

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

Authorized official

Name
Dr. Noble Maseru, PH.D, MPH
Title
Health Commissioner
Phone
(513) 357-7280

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X Primary

Addresses

Primary practice location

2750 Beekman St
Cincinnati, OH 45225-2049

Mailing address

3101 Burnet Ave
Cincinnati, OH 45229-3014
Phone (513) 357-7289

Other identifiers 1

IdentifierTypeStateIssuer
0502807MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090922000233 OH Part A Provider - Federally Qualified Health Center (FQHC) 3476467804 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Cincinnati, OH

Federally qualified health center certification: CCN 361955

Legal name
CITY OF CINCINNATI
Doing business as
CITY OF CINCINNATI PRIMARY CARE-MILLVALE @HOPPLE HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 1, 2009
Last certification
Dec 1, 2009
Ownership / control type
For profit – corporation
Organization structure
GovernmentNon-profit
Enrollment address
2750 Beekman St
Cincinnati, OH 45225-2049

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Grant Mussman Individual Corporate OfficerCeo Mar 5, 2019 100%
Operational/Managerial ControlCeo Mar 5, 2019 100%
City of Cincinnati Organization, Cincinnati, OH Operational/Managerial Control Jul 15, 2009
Robert Schlanz Individual W-2 Managing EmployeeCfo Oct 29, 2009 100%
Operational/Managerial ControlCfo Oct 29, 2009 100%
Noble Maseru Individual Corporate OfficerHealth Commissioner Oct 27, 2009 100%
W-2 Managing EmployeeHealth Commissioner Oct 27, 2009 100%

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277683200000",
    "number": "1275689671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 BURNET AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293014",
            "telephone_number": "513-357-7289",
            "fax_number": "513-357-7396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2750 BEEKMAN ST",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452252049",
            "telephone_number": "513-352-3192",
            "fax_number": "513-352-3137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF CINCINNATI",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-26",
        "last_updated": "2010-06-28",
        "status": "A",
        "authorized_official_last_name": "MASERU",
        "authorized_official_first_name": "NOBLE",
        "authorized_official_title_or_position": "HEALTH COMMISSIONER",
        "authorized_official_telephone_number": "513-357-7280",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D, MPH"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0502807",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.