NPIMap

Organization Active NPI

Highland Springs Physician Group, LLC

  • Psychiatry Physician
  • Highland Hills, OH
National Provider Identifier
1316682800
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
HIGHLAND SPRINGS PHYSICIAN GROUP, LLC
Practice address
4199 Millpond Dr
Highland Hills, OH 44122-5731
Phone
(216) 242-4760
NPI assigned
Apr 29, 2022
Last updated
Feb 6, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
HIGHLAND SPRINGS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

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

Authorized official

Name
Gina Warren
Title
Director Credentialing & Payor En.
Phone
(502) 381-3338

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X
Psychiatry Physician 2084P0800X Primary

Addresses

Primary practice location

4199 Millpond Dr
Highland Hills, OH 44122-5731

Mailing address

4801 Olympia Park PLZ Ste 1000
Louisville, KY 40241-2090
Phone (412) 588-3546

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220628003767 OH Part B Supplier - Clinic/Group Practice 4183004781 Receives reassigned benefits from 28 practitioners
1 other NPI on this enrollment
Practice locations: Highland Hills, OH; Solon, OH

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
Tax ID family
Highland Springs Physician Group2 organizations share this tax ID, including this one
Part of
Highland Springs LLC

Other organizations with this tax ID 1

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

Locations

34125 Solon Rd
Solon, OH 44139
Phone (412) 588-3546

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 29

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 29

NPI Registry JSON

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

{
    "created_epoch": "1651190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707177600000",
    "number": "1316682800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 OLYMPIA PARK PLZ STE 1000",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402412090",
            "telephone_number": "412-588-3546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4199 MILLPOND DR",
            "city": "HIGHLAND HILLS",
            "state": "OH",
            "postal_code": "441225731",
            "telephone_number": "216-242-4760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGHLAND SPRINGS PHYSICIAN GROUP, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HIGHLAND SPRINGS, LLC",
        "enumeration_date": "2022-04-29",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A",
        "authorized_official_last_name": "WARREN",
        "authorized_official_first_name": "GINA",
        "authorized_official_title_or_position": "DIRECTOR CREDENTIALING & PAYOR EN.",
        "authorized_official_telephone_number": "502-381-3338"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland Hills, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.