NPIMap

Organization Active NPI

Pediatric Products, LLC

  • Durable Medical Equipment & Medical Supplies
  • Cincinnati, OH
National Provider Identifier
1669415394
Registry record updated Dec 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
PEDIATRIC PRODUCTS, LLC
Practice address
2975 Exon Ave
Cincinnati, OH 45241-2520
Phone
(513) 891-4633
Fax
(513) 891-4654
NPI assigned
Jun 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2021

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

Authorized official

Name
Mr. Randy Paulson
Title
Ceo
Phone
(513) 891-4633

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

2975 Exon Ave
Cincinnati, OH 45241-2520

Mailing address

2975 Exon Ave
Cincinnati, OH 45241-2520
Phone (513) 891-4633

Other identifiers 3

IdentifierTypeStateIssuer
2532254MedicaidOH
90012857MedicaidKY
200503130AMedicaidIN

Other names 1

  • Xpress Nebs Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930082903 OH DME Supplier - Medical Supply Company 3274744487 1 other NPI on this enrollment
Practice locations: Cincinnati, OH

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Pediatric Products, LLC2975 Exon Ave, Cincinnati, OH 45241-2520(513) 891-4633 Ultraviolet Light Devices and/or Supplies|Nebulizer Equipment and/or Supplies Accepts assignmentParticipating since Apr 11, 2005

National Provider Directory

National Provider Directory
Tax ID family
Pediatric Products LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

2975 Exon Ave
Ste A
Cincinnati, OH 45241
Phone (513) 891-4633

NPI Registry JSON

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639008000000",
    "number": "1669415394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2975 EXON AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452412520",
            "telephone_number": "513-891-4633",
            "fax_number": "513-891-4654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2975 EXON AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452412520",
            "telephone_number": "513-891-4633",
            "fax_number": "513-891-4654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC PRODUCTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-13",
        "last_updated": "2021-12-09",
        "certification_date": "2021-12-09",
        "status": "A",
        "authorized_official_last_name": "PAULSON",
        "authorized_official_first_name": "RANDY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "513-891-4633",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2532254",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "90012857",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200503130A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Xpress Nebs",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Xpress Nebs",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.