NPIMap

Organization Active NPI

K&G Dedicated Long-Term Care Associates LLC

  • Hospitalist Physician
  • Cincinnati, OH
National Provider Identifier
1730735069
Registry record updated Mar 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
Legal business name
K&G DEDICATED LONG-TERM CARE ASSOCIATES LLC
Practice address
2155 Dana Ave
Cincinnati, OH 45207-1340
Phone
(513) 843-7716
Fax
(513) 718-3223
NPI assigned
Aug 13, 2019
Last updated
Mar 14, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2023

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

Authorized official

Name
Kenrick Richardson, MDNPI 1295736049
Title
President/MD
Phone
(513) 843-7632

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU
Hospitalist Physician 208M00000X NU Primary

Addresses

Primary practice location

2155 Dana Ave
Cincinnati, OH 45207-1340

Mailing address

71 Vista Ridge Dr
South Lebanon, OH 45065-8755
Phone (513) 843-7716

Other practice location 1

707 S Edwin C Moses Blvd
Dayton, OH 45417-3462
Phone (513) 508-8945

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191025001644 OH Part B Supplier - Clinic/Group Practice 0345572244 Receives reassigned benefits from 12 practitioners
Practice locations: Cincinnati, OH; Dayton, OH; West Chester, OH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

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": "1565654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678752000000",
    "number": "1730735069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 VISTA RIDGE DR",
            "city": "SOUTH LEBANON",
            "state": "OH",
            "postal_code": "450658755",
            "telephone_number": "513-843-7716",
            "fax_number": "513-718-3223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2155 DANA AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452071340",
            "telephone_number": "513-843-7716",
            "fax_number": "513-718-3223"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "707 S Edwin C Moses Blvd",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454173462",
            "country_code": "US",
            "telephone_number": "513-508-8945",
            "fax_number": "513-843-7945",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "K&G DEDICATED LONG-TERM CARE ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-13",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "KENRICK",
        "authorized_official_title_or_position": "PRESIDENT/MD",
        "authorized_official_telephone_number": "513-843-7632",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NU",
            "license": null,
            "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 Mar 14, 2023; 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.