NPIMap

Organization Active NPI

Tri-State Internal Medicine, LLC

  • Internal Medicine Physician
  • Mason, OH
National Provider Identifier
1982892881
Registry record updated Oct 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
34006559 Issued in OH
Legal business name
TRI-STATE INTERNAL MEDICINE, LLC
Practice address
7450 S Mason Montgomery Rd
Suite #200
Mason, OH 45040-7891
Phone
(513) 229-4900
Fax
(513) 229-4903
NPI assigned
Oct 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2007

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

Authorized official

Name
Dr. Scott Aaron Kotzin, D.O.NPI 1215915442
Title
Owner
Phone
(513) 229-4900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 34006559 OH Primary

Addresses

Primary practice location

7450 S Mason Montgomery Rd
Suite #200
Mason, OH 45040-7891

Mailing address

7450 S Mason Montgomery Rd
Suite #200
Mason, OH 45040-7891
Phone (513) 229-4900

Other identifiers 1

IdentifierTypeStateIssuer
2344967MedicaidOH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1191542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191542400000",
    "number": "1982892881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7450 S MASON MONTGOMERY RD",
            "address_2": "SUITE #200",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450407891",
            "telephone_number": "513-229-4900",
            "fax_number": "513-229-4903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7450 S MASON MONTGOMERY RD",
            "address_2": "SUITE #200",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450407891",
            "telephone_number": "513-229-4900",
            "fax_number": "513-229-4903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-STATE INTERNAL MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-05",
        "last_updated": "2007-10-05",
        "status": "A",
        "authorized_official_last_name": "KOTZIN",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "AARON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "513-229-4900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "34006559",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2344967",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mason, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.