NPIMap

Organization Active NPI

CT at Midtown

  • Diagnostic Radiology Physician
  • Cincinnati, OH
National Provider Identifier
1508856667
Registry record updated Dec 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
0613IC Issued in OH
Legal business name
CT AT MIDTOWN
Practice address
5400 Kennedy Ave
Cincinnati, OH 45213-2664
Phone
(513) 281-3400
Fax
(513) 527-2275
NPI assigned
Oct 28, 2005
Last updated
Dec 11, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2012

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

Authorized official

Name
Karen E Amaya
Title
Senior Director Corporate Admin
Phone
(513) 924-5174

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 0613IC OH Primary

Addresses

Primary practice location

5400 Kennedy Ave
Cincinnati, OH 45213-2664

Mailing address

5400 Kennedy Ave
Cincinnati, OH 45213-2664
Phone (513) 281-3400

Other identifiers 3

IdentifierTypeStateIssuer
86000452MedicaidKY
000000076292OtherOHANTHEM PIN
2141239MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110516000012 OH Part B Supplier - Clinic/Group Practice 9335045681 Receives reassigned benefits from 76 practitioners
Practice locations: Cincinnati, OH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 76

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 76

NPI Registry JSON

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

{
    "created_epoch": "1130457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355184000000",
    "number": "1508856667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 KENNEDY AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452132664",
            "telephone_number": "513-281-3400",
            "fax_number": "513-527-2275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 KENNEDY AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452132664",
            "telephone_number": "513-281-3400",
            "fax_number": "513-527-2275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CT AT MIDTOWN",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-28",
        "last_updated": "2012-12-11",
        "status": "A",
        "authorized_official_last_name": "AMAYA",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "SENIOR DIRECTOR CORPORATE ADMIN",
        "authorized_official_telephone_number": "513-924-5174"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "0613IC",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "86000452",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PIN",
            "identifier": "000000076292",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2141239",
            "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 Dec 11, 2012; 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.