Organization Active NPI

Mid-City Pediatrics, Inc

  • Pediatrics Physician
  • Cincinnati, OH
National Provider Identifier
1740337799
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
35-04-4973-G Issued in OH
Legal business name
MID-CITY PEDIATRICS, INC
Practice address
8250 Kenwood Crossing Way
Suite 205
Cincinnati, OH 45236-3668
Phone
(513) 948-8444
Fax
(513) 948-0756
NPI assigned
Jan 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Camille Graham, M.D.
Title
President
Phone
(513) 948-8444

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 35-04-4973-G OH Primary

Addresses

Primary practice location

8250 Kenwood Crossing Way
Suite 205
Cincinnati, OH 45236-3668

Mailing address

8250 Kenwood Crossing Way
Suite 205
Cincinnati, OH 45236-3668
Phone (513) 948-8444

Other identifiers 1

IdentifierTypeStateIssuer
0784030MedicaidOH

National Provider Directory

National Provider Directory

Locations

7710 Reading Rd
Ste 120
Cincinnati, OH 45237

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1740337799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8250 KENWOOD CROSSING WAY",
            "address_2": "SUITE 205",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452363668",
            "telephone_number": "513-948-8444",
            "fax_number": "513-948-0756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8250 KENWOOD CROSSING WAY",
            "address_2": "SUITE 205",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452363668",
            "telephone_number": "513-948-8444",
            "fax_number": "513-948-0756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-CITY PEDIATRICS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "CAMILLE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "513-948-8444",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35-04-4973-G",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0784030",
            "state": "OH"
        }
    ],
    "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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.