NPIMap

Organization Active NPI

Pediatric Associates of Mt. Carmel, Inc.

  • Primary Care Clinic/Center
  • Cincinnati, OH
National Provider Identifier
1912110990
Registry record updated Dec 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
PEDIATRIC ASSOCIATES OF MT. CARMEL, INC.
Practice address
4371 Ferguson Drive
Cincinnati, OH 45245
Phone
(513) 752-3650
Fax
(513) 752-3387
NPI assigned
May 7, 2007
Last updated
Dec 10, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2013

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

Authorized official

Name
Michael Ann Chamberlin
Title
President
Phone
(513) 752-3650

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

4371 Ferguson Drive
Cincinnati, OH 45245

Mailing address

4371 Ferguson Drive
Cincinnati, OH 45245
Phone (513) 752-3650

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210513002562 OH Part B Supplier - Mass Immunization (Roster Biller Only) 0648689158 Practice locations: Cincinnati, OH

National Provider Directory

National Provider Directory

Locations

3333 Burnet Ave
Ste 6015
Cincinnati, OH 45229

4834 Socialville Foster Rd
Ste 50
Mason, OH 45040

Practitioners & affiliated clinicians

Practitioners 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386633600000",
    "number": "1912110990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4371 FERGUSON DRIVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "45245",
            "telephone_number": "513-752-3650",
            "fax_number": "513-752-3387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4371 FERGUSON DRIVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "45245",
            "telephone_number": "513-752-3650",
            "fax_number": "513-752-3387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC ASSOCIATES OF MT. CARMEL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-07",
        "last_updated": "2013-12-10",
        "status": "A",
        "authorized_official_last_name": "CHAMBERLIN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "513-752-3650"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "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 Dec 10, 2013; 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.