NPIMap

Organization Active NPI

Full Spectrum Health Center LLC

  • Specialist
  • Cincinnati, OH
National Provider Identifier
1629275177
Registry record updated May 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
35071837S Issued in OH
Legal business name
FULL SPECTRUM HEALTH CENTER LLC
Practice address
3836 Reading Rd
Cincinnati, OH 45229-1535
Phone
(513) 221-2111
Fax
(513) 221-0111
NPI assigned
Jun 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2008

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

Authorized official

Name
Dr. Dorothy P Shaffer, MDNPI 1467444976
Title
Owner
Phone
(513) 221-2111

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
SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 174400000X 35071837S OH Primary

Addresses

Primary practice location

3836 Reading Rd
Cincinnati, OH 45229-1535

Mailing address

3836 Reading Rd
Cincinnati, OH 45229-1535
Phone (513) 221-2111

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080206000499 OH Part B Supplier - Clinic/Group Practice 0749363224 Receives reassigned benefits from 2 practitioners
Practice locations: Cincinnati, OH

National Provider Directory

National Provider Directory

Locations

3836 Reading Rd
Cincinnati, OH 45229
Phone (513) 221-2111

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9187/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1182988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212105600000",
    "number": "1629275177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3836 READING RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452291535",
            "telephone_number": "513-221-2111",
            "fax_number": "513-221-0111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3836 READING RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452291535",
            "telephone_number": "513-221-2111",
            "fax_number": "513-221-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULL SPECTRUM HEALTH CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-28",
        "last_updated": "2008-05-30",
        "status": "A",
        "authorized_official_last_name": "SHAFFER",
        "authorized_official_first_name": "DOROTHY",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "513-221-2111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "OH",
            "license": "35071837S",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 May 30, 2008; 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.