Active NPI
Drake Pavilion, LLC
- General Acute Care Hospital
- Cincinnati, OH
National Provider Identifier
1558355495
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Acute Care Hospital
- Legal business name
- DRAKE PAVILION, LLC
- Practice address
- 2139 Auburn Ave
Cincinnati, OH 45219-2906 - Phone
- (513) 585-0352
- Fax
- (513) 585-0340
- NPI assigned
- Sep 7, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Donald Kob, MHA
- Title
- Business Manager
- Phone
- (513) 585-0352
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Acute Care Hospital | 282N00000X | Primary |
Addresses
Primary practice location
2139 Auburn Ave
Cincinnati, OH 45219-2906
Mailing address
2139 Auburn Ave
Cincinnati, OH 45219-2906
Phone (513) 585-0352
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2450673 | Medicaid | OH | |
| 000000318917 | Other | OH | ANTHEM OHIO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Hospital certification: CCN 360264
Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.
- Legal name
- DRAKE PAVILION,LLC
- Certification status
- Terminated Voluntary: merger or closure, Jan 1, 2004
- Provider type (POS)
- Hospital – Short-term
- Participating since
- Feb 21, 2003
- Last certification
- Feb 21, 2003
- Beds
- 30
- Ownership / control type
- Private (not for profit)
- Facility address
- 2139 Auburn Avenue
Cincinnati, OH 45219
Hospital certification: CCN 362030
Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.
- Legal name
- DRAKE PAVILION, LLC
- Certification status
- Terminated Voluntary: merger or closure, Apr 1, 2006
- Provider type (POS)
- Hospital – Long-term
- Participating since
- Jan 1, 2004
- Last certification
- Jan 1, 2004
- Beds
- 30
- Ownership / control type
- Private (not for profit)
- Facility address
- 2139 Auburn Avenue
Cincinnati, OH 45219
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126051200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1558355495",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2139 AUBURN AVE",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452192906",
"telephone_number": "513-585-0352",
"fax_number": "513-585-0340"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2139 AUBURN AVE",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452192906",
"telephone_number": "513-585-0352",
"fax_number": "513-585-0340"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DRAKE PAVILION, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2005-09-07",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "KOB",
"authorized_official_first_name": "DONALD",
"authorized_official_title_or_position": "BUSINESS MANAGER",
"authorized_official_telephone_number": "513-585-0352",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "MHA"
},
"taxonomies": [
{
"code": "282N00000X",
"taxonomy_group": "",
"desc": "General Acute Care Hospital",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2450673",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM OHIO",
"identifier": "000000318917",
"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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.