NPIMap

Organization Active NPI

Brett Coldiron MD

  • Dermatology Physician
  • Cincinnati, OH
National Provider Identifier
1497842124
Registry record updated Sep 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
35-049740 Issued in OH
Legal business name
BRETT COLDIRON MD
Practice address
3024 Burnet Ave
Cincinnati, OH 45219-2420
Phone
(513) 221-2828
NPI assigned
Oct 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2007

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

Authorized official

Name
Brett Coldiron, MDNPI 1144297847
Title
President
Phone
(513) 221-2828

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X 35-049740 OH Primary

Addresses

Primary practice location

3024 Burnet Ave
Cincinnati, OH 45219-2420

Mailing address

200 Northland Blvd FL 1
Cincinnati, OH 45246-3604
Phone (513) 672-4128

Other identifiers 2

IdentifierTypeStateIssuer
64869621MedicaidKY
0566847MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070227000352 OH Part B Supplier - Clinic/Group Practice 3375543762 Receives reassigned benefits from 6 practitioners
Practice locations: Cincinnati, OH

National Provider Directory

National Provider Directory
Tax ID family
Brett Coldiron MD3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

11151 Kenwood Rd
Ste B
Blue Ash, OH 45242
Phone (513) 256-8272

580 Walnut St
Ste P160
Cincinnati, OH 45202

200 Northland Blvd
Fl 1
Cincinnati, OH 45246

5184 Socialville Foster Rd
Mason, OH 45040
Phone (513) 770-0953

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189555200000",
    "number": "1497842124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 NORTHLAND BLVD FL 1",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452463604",
            "telephone_number": "513-672-4128",
            "fax_number": "513-672-4479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3024 BURNET AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452192420",
            "telephone_number": "513-221-2828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRETT COLDIRON MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2007-09-12",
        "status": "A",
        "authorized_official_last_name": "COLDIRON",
        "authorized_official_first_name": "BRETT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "513-221-2828",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "OH",
            "license": "35-049740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64869621",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0566847",
            "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 Sep 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.