Organization Active NPI

Northeast Center for Women's Health, Inc.

  • Obstetrics & Gynecology Physician
  • Cincinnati, OH
National Provider Identifier
1396764528
Registry record updated Apr 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
NORTHEAST CENTER FOR WOMEN'S HEALTH, INC.
Practice address
11135 Montgomery Rd
Cincinnati, OH 45249-2338
Phone
(513) 793-2220
Fax
(513) 793-5933
NPI assigned
Jul 19, 2006
Last updated
Apr 17, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2013

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

Authorized official

Name
Dr. Jon Richard Fackler, MDNPI 1497784722
Title
Co-Owner
Phone
(513) 793-2220

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X OH
Obstetrics & Gynecology Physician 207V00000X NU Primary

Addresses

Primary practice location

11135 Montgomery Rd
Cincinnati, OH 45249-2338

Mailing address

11135 Montgomery Rd
Cincinnati, OH 45249-2338
Phone (513) 793-2220

Other identifiers 1

IdentifierTypeStateIssuer
2005038MedicaidOH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366156800000",
    "number": "1396764528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11135 MONTGOMERY RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452492338",
            "telephone_number": "513-793-2220",
            "fax_number": "513-793-5933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11135 MONTGOMERY RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452492338",
            "telephone_number": "513-793-2220",
            "fax_number": "513-793-5933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST CENTER FOR WOMEN'S HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-19",
        "last_updated": "2013-04-17",
        "status": "A",
        "authorized_official_last_name": "FACKLER",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "513-793-2220",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2005038",
            "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 Apr 17, 2013; 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.