NPIMap

Organization Active NPI

Dedicated Ohio Holding, LLC

Doing business as Dedicated Senior Medical Center Mt. Airy

  • Non-Pharmacy Dispensing Site
  • Cincinnati, OH
National Provider Identifier
1407475643
Registry record updated Apr 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
Legal business name
DEDICATED OHIO HOLDING, LLC
Doing business as
Dedicated Senior Medical Center Mt. Airy
Practice address
6121 Colerain Ave
Cincinnati, OH 45239
Phone
(513) 354-2466
NPI assigned
Apr 8, 2020
Last updated
Apr 10, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
DEDICATED OHIO HOLDING, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 10, 2020

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

Authorized official

Name
Mary Chen
Title
Owner
Phone
(305) 628-6117

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X Primary

Addresses

Primary practice location

6121 Colerain Ave
Cincinnati, OH 45239

Mailing address

1395 NW 167TH St
Miami, FL 33169-5710
Phone (305) 628-6117

Other names 1

  • Dedicated Senior Medical Center Mt. Airy Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D2188009Dedicated Senior Medical Center6121 Colerain Avenue, Cincinnati, OH 45239Certificate of waiverJul 9, 2028

National Provider Directory

National Provider Directory
Tax ID family
Dedicated Ohio Holding LLC6 organizations share this tax ID, including this one
Part of
Dedicated Ohio Holding LLC

Other organizations with this tax ID 5

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

Locations

6121 Colerain Ave
Cincinnati, OH 45239
Phone (513) 354-2466

Practitioners & affiliated clinicians

Practitioners 14

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 14

NPI Registry JSON

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

{
    "created_epoch": "1586304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586476800000",
    "number": "1407475643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 NW 167TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331695710",
            "telephone_number": "305-628-6117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6121 COLERAIN AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "45239",
            "telephone_number": "513-354-2466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEDICATED OHIO HOLDING, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DEDICATED OHIO HOLDING, LLC",
        "enumeration_date": "2020-04-08",
        "last_updated": "2020-04-10",
        "certification_date": "2020-04-10",
        "status": "A",
        "authorized_official_last_name": "CHEN",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-628-6117"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dedicated Senior Medical Center Mt. Airy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dedicated Senior Medical Center Mt. Airy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.