NPIMap

Organization Active NPI

Muddy Creek Pediatrics LLC

  • Pediatrics Physician
  • Mason, OH
National Provider Identifier
1417081092
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
MUDDY CREEK PEDIATRICS LLC
Practice address
608 Reading Rd Ste D
Mason, OH 45040-1561
Phone
(513) 398-3900
Fax
(513) 398-4950
NPI assigned
Mar 15, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Todd D Habel, M.D.NPI 1316001258
Title
Owner
Phone
(513) 398-3900

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X NU Primary

Addresses

Primary practice location

608 Reading Rd Ste D
Mason, OH 45040-1561

Mailing address

608 Reading Rd Ste D
Mason, OH 45040-1561
Phone (513) 398-3900

Other identifiers 1

IdentifierTypeStateIssuer
000000284778OtherOHANTHEM BCBS

National Provider Directory

National Provider Directory

Locations

608 Reading Rd
Ste D
Mason, OH 45040
Phone (513) 398-3900

Practitioners & affiliated clinicians

Practitioners 7

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": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1417081092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 READING RD STE D",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450401561",
            "telephone_number": "513-398-3900",
            "fax_number": "513-398-4950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 READING RD STE D",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450401561",
            "telephone_number": "513-398-3900",
            "fax_number": "513-398-4950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUDDY CREEK PEDIATRICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HABEL",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "513-398-3900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000284778",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mason, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.