Active NPI
City of Cincinnati
- Community Health Clinic/Center
- Cincinnati, OH
National Provider Identifier
1275689671
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Clinic/Center
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0502807 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- Government
- 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.
-
- Federally Qualified Health Center (FQHC)
- Cincinnati, OH
- NPI 1073836797
O20090922000233
National Provider Directory
National Provider DirectoryOwnership & 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.
| Name | Role | Since | Share |
|---|---|---|---|
| Grant Mussman | Corporate Officer | Mar 5, 2019 | 100% |
| Operational/Managerial Control | Mar 5, 2019 | 100% | |
| City of Cincinnati | Operational/Managerial Control | Jul 15, 2009 | |
| Robert Schlanz | W-2 Managing Employee | Oct 29, 2009 | 100% |
| Operational/Managerial Control | Oct 29, 2009 | 100% | |
| Noble Maseru | Corporate Officer | Oct 27, 2009 | 100% |
| W-2 Managing Employee | 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.