Bruce Lyle Tetirick, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

35042511 Issued in OH

Practice address

9312 Winton Rd
Cincinnati, OH 45231-3938

Phone

(513) 922-0009

Fax

(513) 931-2481

NPI assigned

May 31, 2005

Last updated

Jul 31, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: btetirick@shwhc.gwaydirect.com

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438300800000",
    "number": "1518960830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2060 READING RD",
            "address_2": "SUITE 150",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452021454",
            "telephone_number": "513-721-3200",
            "fax_number": "513-639-3186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9312 WINTON RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452313938",
            "telephone_number": "513-922-0009",
            "fax_number": "513-931-2481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TETIRICK",
        "first_name": "BRUCE",
        "middle_name": "LYLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-31",
        "last_updated": "2015-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OH",
            "license": "35042511",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000021056",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "990127",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "720619",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0580625",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00149781",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "288089",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE",
            "identifier": "31157505137",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dana Rae Tesdahl, L.P.N.
• Addisalem Tesmama, NP
• Adam Doyle Testerman, DPT
• Kelly Testerman
• Kathleen M. Teters, RN
• Patricia A Tetirick, NP
• Ashley Tettenhorst, OTR/L
• Amit Tevar
• John M Tew Jr., M.D.
• Texoma Dialysis LLC (Affinity Place Dialysis)

• Obstetrics & Gynecology Physician in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Obstetrics & Gynecology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2015; 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.