Southern Ohio Nephrology, Inc.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

SOUTHERN OHIO NEPHROLOGY, INC.

Practice address

1711 27TH St
Braunlin BLDG. (K) Ste 301
Portsmouth, OH 45662-2654

Phone

(740) 354-5393

Fax

(740) 353-9068

NPI assigned

Jan 2, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Reena Samuel-Variath, M.D.

Title

President

Phone

(740) 354-5393

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Locations

Practitioners 2

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

• Ernesto E Banalagay, M.D.

  • Nephrology Physician
  • Portsmouth, OH
  • NPI 1629135470

  Nephrology, OH

  Medicare reassignment NPD
• Reena P Samuel, M.D.

  • Nephrology Physician
  • Portsmouth, OH
  • NPI 1629135462

  Nephrology, OH

  Medicare reassignment NPD

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316476800000",
    "number": "1962569749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1711 27TH ST",
            "address_2": "BRAUNLIN BLDG. (K) STE 301",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456622654",
            "telephone_number": "740-354-5393",
            "fax_number": "740-353-9068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 27TH ST",
            "address_2": "BRAUNLIN BLDG. (K) STE 301",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456622654",
            "telephone_number": "740-354-5393",
            "fax_number": "740-353-9068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN OHIO NEPHROLOGY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2011-09-20",
        "status": "A",
        "authorized_official_last_name": "SAMUEL-VARIATH",
        "authorized_official_first_name": "REENA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "740-354-5393",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2222919",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Southern Ohio Medical Center
• Southern Ohio Medical Center
• Southern Ohio Medical Center
• Southern Ohio Medical Center
• Southern Ohio Medical Imaging Consultants Inc
• Southern Ohio Radiologists Inc
• Southern Ohio Regional Pathology, Inc
• Southern Ohio Surgical Associates, Inc.
• Laura Sova, FNP-C
• Kala R Sowards Rhea, CDCA

• All providers in Portsmouth, OH
• Nephrology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2011; 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.