Dr. Jerry H. McDaniel, MD, Inc

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

35047141 Issued in OH

Legal business name

DR. JERRY H. MCDANIEL, MD, INC

Practice address

375 Glensprings Dr
Suite 410
Cincinnati, OH 45246-2316

Phone

(513) 851-6500

Fax

(513) 851-0265

NPI assigned

Jun 6, 2011

Organization subpart

No

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

Authorized official

Name

Denise Grimes

Title

Office Manager

Phone

(513) 851-6500

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1307318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307318400000",
    "number": "1891089983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 GLENSPRINGS DR",
            "address_2": "SUITE 410",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452462316",
            "telephone_number": "513-851-6500",
            "fax_number": "513-851-0265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 GLENSPRINGS DR",
            "address_2": "SUITE 410",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452462316",
            "telephone_number": "513-851-6500",
            "fax_number": "513-851-0265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. JERRY H. MCDANIEL, MD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-06",
        "last_updated": "2011-06-06",
        "status": "A",
        "authorized_official_last_name": "GRIMES",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "513-851-6500"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "OH",
            "license": "35047141",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0489921",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Primary Care Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 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.

Verify at the official NPI Registry.