Individual provider Active NPI

Cory L Pelnick, MD

  • Psychiatry Physician
  • Wilmington, OH
National Provider Identifier
1912027376
Registry record updated Apr 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
35-074220 Issued in OH
Practice address
953 S South Street
Wilmington, OH 45177-2921
Phone
(937) 383-4441
Fax
(937) 383-2348
NPI assigned
Mar 30, 2007
Last updated
Apr 30, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 35-074220 OH Primary

Addresses

Primary practice location

953 S South Street
Wilmington, OH 45177-2921

Mailing address

975 Kingsview Drive
Suite 400
Lebanon, OH 45036-8336
Phone (513) 228-7854

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130607000229 OH Practitioner - Psychiatry 6305084021 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Talbert HouseGroup PAC ID 1951314319, 37 clinicians

Practice addresses (Care Compare)

4968 Glenway Ave
Cincinnati, OH 45238-3902
Phone (513) 853-6570

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35-074220OHMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Talbert House CurrentSince Mar 18, 2015 Accepting new patients
CP Psychiatric Services LLC Psychiatry Current Accepting new patients
Community Mental Health Center of Clinton County Past Accepting new patients

Locations

1515 Carll St
Cincinnati, OH 45225
Phone (513) 244-3985

2600 Victory Pkwy
Cincinnati, OH 45206
Phone (513) 872-5863

4968 Glenway Ave
Cincinnati, OH 45238
Phone (513) 471-6000

204 Cook Rd
Lebanon, OH 45036
Phone (513) 695-1357

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367280000000",
    "number": "1912027376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 KINGSVIEW DRIVE",
            "address_2": "SUITE 400",
            "city": "LEBANON",
            "state": "OH",
            "postal_code": "450368336",
            "telephone_number": "513-228-7854",
            "fax_number": "513-228-7848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "953 S SOUTH STREET",
            "city": "WILMINGTON",
            "state": "OH",
            "postal_code": "451772921",
            "telephone_number": "937-383-4441",
            "fax_number": "937-383-2348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELNICK",
        "first_name": "CORY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-30",
        "last_updated": "2013-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35-074220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, OH

Sources for this page

Verify at the official NPI Registry.