Individual provider Active NPI

Rodney E. Vivian, M.D.

  • Psychiatry Physician
  • Cincinnati, OH
National Provider Identifier
1295763845
Registry record updated Jan 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
35041575 Issued in OH
Practice address
4452 Eastgate Blvd Ste 202
Cincinnati, OH 45245-1584
Phone
(513) 232-3070
Fax
(513) 232-5794
NPI assigned
Jun 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 35041575 OH Primary

Addresses

Primary practice location

4452 Eastgate Blvd Ste 202
Cincinnati, OH 45245-1584

Mailing address

PO Box 635283
Cincinnati, OH 45263-5283
Phone (859) 301-5901

Other identifiers 3

IdentifierTypeStateIssuer
000000011245OtherOHANTHEM
0401827MedicaidOH
036793000OtherOHMAGELLAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040119000314 OH Practitioner - Psychiatry 8022919422 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Cincinnati College of Medicine, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rodney E. Vivian MD IncGroup PAC ID 5294768768, 4 clinicians

Practice addresses (Care Compare)

4452 Eastgate Blvd
Suite 202
Cincinnati, OH 45245-1584
Phone (513) 232-3070

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35041575OHMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rodney E. Vivian MD Inc CurrentSince Aug 2, 1982 Accepting new patients

Locations

8000 5 Mile Rd
Ste 240
Cincinnati, OH 45230
Phone (513) 232-3070

4452 Eastgate Blvd
Ste 202
Cincinnati, OH 45245
Phone (513) 232-3070

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672963200000",
    "number": "1295763845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 635283",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452635283",
            "telephone_number": "859-301-5901",
            "fax_number": "859-301-5940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4452 EASTGATE BLVD STE 202",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452451584",
            "telephone_number": "513-232-3070",
            "fax_number": "513-232-5794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIVIAN",
        "first_name": "RODNEY",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2023-01-06",
        "certification_date": "2023-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35041575",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000011245",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0401827",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "036793000",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.