Easter Seals Tristate, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

EASTER SEALS TRISTATE, LLC

Doing business as

Easterseals Redwood

Practice address

2840 Meirose Ave
Cincinnati, OH 45206

Phone

(513) 281-2316

NPI assigned

Feb 27, 2017

Organization subpart

No

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

Authorized official

Name

Ms. Pam Green

Title

President/Ceo

Phone

(513) 281-2316

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Easterseals Redwood Doing business as

Locations

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

{
    "created_epoch": "1488153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689897600000",
    "number": "1417497223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 GILBERT AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452061211",
            "telephone_number": "513-281-2316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2840 MEIROSE AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "45206",
            "telephone_number": "513-281-2316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTER SEALS TRISTATE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-27",
        "last_updated": "2023-07-21",
        "certification_date": "2023-07-21",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "PAM",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "513-281-2316",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0065757",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Easterseals Redwood",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Physical Therapist in Cincinnati, OH
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2023; 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.