NPIMap

Organization Active NPI

City of Cincinnati

  • Federally Qualified Health Center (FQHC)
  • Cincinnati, OH
National Provider Identifier
1689021230
Registry record updated May 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
CITY OF CINCINNATI
Practice address
420 Ezzard Charles Dr
Cincinnati, OH 45214-2806
Phone
(513) 363-8221
NPI assigned
May 24, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2016

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

Authorized official

Name
Dr. Noble Maseru
Title
Health Commissioner
Phone
(513) 357-7280

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

420 Ezzard Charles Dr
Cincinnati, OH 45214-2806

Mailing address

3101 Burnet Ave
Cincinnati, OH 45229-3014
Phone (513) 357-2809

Other names 1

  • Taft High School Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160916001034 OH Part A Provider - Federally Qualified Health Center (FQHC) 3476467804 Practice locations: Cincinnati, OH

Federally qualified health center certification: CCN 361111

Legal name
CITY OF CINCINNATI
Doing business as
CINCINNATI HEALTH DEPARTMENT - TAFT HIGH SCHOOL
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 13, 2016
Last certification
Sep 13, 2016
Ownership / control type
For profit – corporation
Organization structure
GovernmentNon-profit
Enrollment address
420 Ezzard Charles Dr
Cincinnati, OH 45214-2806

National Provider Directory

National Provider Directory
Tax ID family
Roberts Paideia Academy44 organizations share this tax ID, including this one

Other organizations with this tax ID 43

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

View all 43

Ownership & related parties

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Grant Mussman Individual Corporate DirectorInterim Health Commissioner Dec 1, 2020 100%
W-2 Managing EmployeeInterim Health Commissioner Dec 1, 2020 100%
Operational/Managerial ControlInterim Health Commissioner Dec 1, 2020 100%
City of Cincinnati Organization, Cincinnati, OH 5% Or Greater Direct Ownership Interest Jan 12, 2006 100%
Operational/Managerial Control Jan 12, 2006 100%
Lauren Thamann-Raines Individual W-2 Managing EmployeeSenior Administrative Specialist Jun 24, 2012

All facility ownership & control disclosures 19

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
City of Cincinnati-Braxton Cann Memorial Medical CenterCincinnati, OH, CCN 361954 Federally qualified health center Operational/Managerial Control Jul 15, 2009
City of Cincinnati Primary Care-Millvale @Hopple Health CenterCincinnati, OH, CCN 361955 Federally qualified health center Operational/Managerial Control Jul 15, 2009
Northside Health CenterCincinnati, OH, CCN 361956 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1970
Ambrose H. Clement Health CenterCincinnati, OH, CCN 361957 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1980
Crest Smile ShoppeCincinnati, OH, CCN 361958 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1980
City of CincinnatiCincinnati, OH, CCN 361803 Federally qualified health center Operational/Managerial Control Jul 15, 2010
Price Hill Health CenterCincinnati, OH, CCN 361816 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) May 16, 1976
Cincinnati Health Department - John P. Parker SBHCCincinnati, OH, CCN 361068 Federally qualified health center Operational/Managerial Control Jan 12, 2006
Cincinnati Health Department - Riverview East SBHCCincinnati, OH, CCN 361066 Federally qualified health center Operational/Managerial Control (100%) Jan 12, 2006
Cincinnati Health Department - Mt Airy SBHCCincinnati, OH, CCN 361067 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jan 12, 2006
Cincinnati Health Department - the Children'S Home of CincinnatiCincinnati, OH, CCN 361110 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jun 1, 2016
Jan 12, 2006
Roll Hill AcademyCincinnati, OH, CCN 361145 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2017
Oyler Community Learning CenterCincinnati, OH, CCN 361146 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2017
City of CincinnatiCincinnati, OH, CCN 361151 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2017
Roberts PaideiaCincinnati, OH, CCN 361153 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2017
Ethel M Taylor AcademyCincinnati, OH, CCN 361152 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2017
Cincinnati Health Department - Deaconess Health Check at Western HillsCincinnati, OH, CCN 361167 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Aug 1, 2012
Jan 12, 2006
Cincinnati Health Department - Withrow High SchoolCincinnati, OH, CCN 361168 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 12, 2006
Jan 12, 2006
Cincinnati Health Department - Academy of World Languages SBHCCincinnati, OH, CCN 361169 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 12, 2006
Jan 12, 2006

Facilities with the same owner 19

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1464048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464048000000",
    "number": "1689021230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 BURNET AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293014",
            "telephone_number": "513-357-2809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 EZZARD CHARLES DR",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452142806",
            "telephone_number": "513-363-8221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF CINCINNATI",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-24",
        "last_updated": "2016-05-24",
        "status": "A",
        "authorized_official_last_name": "MASERU",
        "authorized_official_first_name": "NOBLE",
        "authorized_official_title_or_position": "HEALTH COMMISSIONER",
        "authorized_official_telephone_number": "513-357-7280",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Taft High School",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.