Active NPI
John P Clancy, M.D.
- Pediatric Pulmonology Physician
- Cincinnati, OH
National Provider Identifier
1679586275
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Pulmonology Physician
- License
- 35.096868
- Practice address
- 3333 Burnet Ave., ML 2021
Cincinnati Children'S Hospital
Cincinnati, OH 45229-3039 - Phone
- (513) 636-6771
- Fax
- (513) 636-4615
- NPI assigned
- Aug 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Pulmonology Physician | 2080P0214X | 35.096868 | OH | Primary |
Addresses
Primary practice location
3333 Burnet Ave., ML 2021
Cincinnati Children'S Hospital
Cincinnati, OH 45229-3039
Mailing address
3333 Burnet Ave., ML 2021
Cincinnati Children'S Hospital
Cincinnati, OH 45229-3039
Phone (513) 636-6771
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 051503748 | Medicaid | AL | |
| 09523863 | Other | AL | MS MEDICAID |
| 009969010 | Medicaid | AL | |
| 051503748 | Other | AL | BCBS OF AL |
| 290014033 | Other | AL | RR MEDICARE |
| 051503749 | Other | AL | BCBS OF AL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35.096868 | OH | MD | Pediatric Pulmonology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1303344000000",
"number": "1679586275",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3333 BURNET AVE., ML 2021",
"address_2": "CINCINNATI CHILDREN'S HOSPITAL",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452293039",
"telephone_number": "513-636-6771",
"fax_number": "513-636-4615"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3333 BURNET AVE., ML 2021",
"address_2": "CINCINNATI CHILDREN'S HOSPITAL",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452293039",
"telephone_number": "513-636-6771",
"fax_number": "513-636-4615"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLANCY",
"first_name": "JOHN",
"middle_name": "P",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-14",
"last_updated": "2011-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0214X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Pulmonology",
"state": "OH",
"license": "35.096868",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "051503748",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MS MEDICAID",
"identifier": "09523863",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "009969010",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF AL",
"identifier": "051503748",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "290014033",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF AL",
"identifier": "051503749",
"state": "AL"
}
],
"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 Apr 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.