Miller Holdings Brookside, Inc.

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

Legal business name

MILLER HOLDINGS BROOKSIDE, INC.

Practice address

780 Snider Rd
Mason, OH 45040-1309

Phone

(513) 398-1020

Fax

(513) 398-5228

NPI assigned

Nov 30, 2006

Organization subpart

No

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

Authorized official

Name

Kurt Miller

Title

President

Phone

(330) 307-6816

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Brookside Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

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

• Manish Srivastava, MD

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Cincinnati, OH
  • NPI 1538283627
  NPD (past)

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1356652800000",
    "number": "1932276086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2460 ELM RD NE",
            "address_2": "SUITE 600",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444832900",
            "telephone_number": "330-307-6816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 SNIDER RD",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450401309",
            "telephone_number": "513-398-1020",
            "fax_number": "513-398-5228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLER HOLDINGS BROOKSIDE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2012-12-28",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "KURT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "330-307-6816"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0072148",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brookside",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Holly S Michel
• Jason Middleton
• Sulbha V Midha, D.D.S
• Midwest Hospice, Inc.
• Jennifer Milau
• Diane Jacqueline Miller Mandell, MSSA LISW
• Jonathan Miller
• Kierra Miller, OTR
• Matthew Miller, PHARMD, RPH
• Paul Miller

• Intellectual Disabilities Intermediate Care Facility in Mason, OH
• Providers in Mason, OH by specialty
• Intellectual Disabilities Intermediate Care Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.