Active NPI
Northeast Center for Women's Health, Inc.
- Obstetrics & Gynecology Physician
- Cincinnati, OH
National Provider Identifier
1396764528
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- 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, 2013
- 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. Jon Richard Fackler, MD
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2005038 | Medicaid | OH |
National Provider Directory
National Provider DirectoryPractitioners & 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.
-
- Gynecology Physician
- Cincinnati, OH
- NPI 1497784722
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
- Gabrielle North, SWT
- Jeffery North
- Latonya Michelle North, LPN
- Matthew Christopher North, CPNP-AC
- Ntatu North
- Northeast Radiology Inc
- Olivia Northey, COTA
- Northland Hearing Centers, Inc. (Ascent Audiology and Hearing Center)
- Northside Dental Ryan Durner, DDS, LLC (Northside Dental)
- Northstar Home Hospice, LLC
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.