Zachary Pettibone

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

35.132457 Issued in OH

Practice address

4075 Old Western Row Rd
Mason, OH 45040

Phone

(513) 536-4673

Fax

(513) 536-0159

NPI assigned

Apr 10, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Psychiatry

Education

University of Cincinnati College of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lindner Center of Hope Professional AssociatesGroup PAC ID 7012236409, 72 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Cincinnati Medical Center, LLC Hospital, Cincinnati, OH, CCN 360003

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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

• Lindner Center of Hope Professional Associates

  • Psychologist
  • Mason, OH
  • NPI 1124425020
  Medicare reassignment Care Compare group NPD
• The Craig and Frances Lindner Center of Hope

  • Psychiatric Hospital
  • Mason, OH
  • NPI 1023207750
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• University of Cincinnati Medical Center, LLC

  • General Acute Care Hospital
  • Cincinnati, OH
  • NPI 1033154026
  Care Compare affiliation
• University of Cincinnati Medical Center, LLC

  • Ambulance
  • Cincinnati, OH
  • NPI 1689618423

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1397088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1962821447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4075 OLD WESTERN ROW RD",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450403104",
            "telephone_number": "513-536-0246",
            "fax_number": "513-536-0159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4075 OLD WESTERN ROW RD",
            "city": "MASON",
            "state": "OH",
            "postal_code": "45040",
            "telephone_number": "513-536-4673",
            "fax_number": "513-536-0159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTIBONE",
        "first_name": "ZACHARY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-10",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35.132457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Berthold Pembaur, MD
• Amy Lynn Pennetti, RPH
• Kelsey Pepper, CNIM
• Jarred Glenn Pertuset, D.C.
• Amy Lynn Peters, RN
• Marylena Juanna Pettigrew
• Kay Louise Pfeifer, OTR/L
• Annie Phan
• Taylor Phillips
• Physician Services Group, Inc

• Psychiatry Physician in Mason, OH
• Providers in Mason, OH by specialty
• Psychiatry Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.