TRI STATE UROLOGIC SERVICES PSC INC (NPI# 1073746459) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073746459 |
| Entity Type | Organization |
| Organization Name | TRI STATE UROLOGIC SERVICES PSC INC |
| Other Organization Name | THE UROLOGY GROUP |
| Practice Address |
925 Deis Dr Fairfield OH 45014-8130 |
| Mailing Address |
2000 Joseph E Sanker Blvd Cincinnati OH 45212-1979 |
| Practice Telephone | 5138417900 |
| Practice Fax Number | 5138417901 |
| Mailing Telephone | 5138417400 |
| Mailing Fax Number | 5138417402 |
| Enumeration Date | 2009-09-01 |
| Last Update Date | 2020-01-06 |
| Authorized Official Name | EARL L WALZ (CEO) |
| Authorized Official Telephone | 5138417400 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | RAILROAD MEDICARE | CC2433 | 01 |
| OH | 0276946 | 05 |
| Other Name | Type Code |
|---|---|
| THE UROLOGY GROUP | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699237909 | Tri State Urologic Services Psc Inc | Urology | 2123 Auburn Ave Ste 434, Cincinnati, OH 45219-2906 | 2019-04-04 |
| 1073075578 | Tri State Urologic Services Psc Inc | Urology | 7529 State Rd Ste B, Cincinnati, OH 45255-6410 | 2019-04-03 |
| 1275726580 | Tri State Urologic Services Psc Inc | Non-Pharmacy Dispensing Site | 350 Thomas More Pkwy Ste 200, Crestview Hills, KY 41017-5460 | 2007-08-20 |
| 1619200664 | Tri State Urologic Services Psc Inc | Urology | 10220 Alliance Rd, Blue Ash, OH 45242-4710 | 2009-09-09 |
| 1164615746 | Tri State Urologic Services Psc Inc | Urology | 8020 Liberty Way, West Chester, OH 45069-2519 | 2007-08-27 |
| 1013100700 | Tri State Urologic Services Psc Inc | Urology | 110 N Poplar St, Oxford, OH 45056-1204 | 2007-08-25 |
| 1285827972 | Tri State Urologic Services Psc Inc | Urology | 4360 Ferguson Dr Ste 100, Cincinnati, OH 45245-1683 | 2007-08-25 |
| 1396938312 | Tri State Urologic Services Psc Inc | Urology | 3301 Mercy Health Blvd, Suite 525, Cincinnati, OH 45211-1104 | 2007-08-22 |
| 1083807093 | Tri State Urologic Services Psc Inc | Urology | 605 Wilson Creek Rd, Suite 01, Lawrenceburg, IN 47025-2506 | 2007-08-22 |
| 1033302054 | Tri State Urologic Services Psc Inc | Urology | 200 Medical Center Dr Ste 500, Middletown, OH 45005-5183 | 2007-08-22 |
| Street Address |
925 DEIS DR |
| City | FAIRFIELD |
| State | OH |
| Zip Code | 45014-8130 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700820776 | Kevin G Campbell | Urology | 925 Deis Dr, Fairfield, OH 45014-8130 | 2006-06-16 |
| 1164038725 | George Edward Guju Jr. | Nurse Practitioner | 925 Deis Dr, Fairfield, OH 45014-8130 | 2020-09-18 |
| 1942643820 | Matthew Love | Urology | 925 Deis Dr, Fairfield, OH 45014-8130 | 2013-04-10 |
| 1356600969 | Stephen Frederick Kappa | Urology | 925 Deis Dr, Fairfield, OH 45014-8130 | 2012-05-16 |
| 1881856482 | Daniel Francis Robertshaw | Urology | 925 Deis Dr, Fairfield, OH 45014-8130 | 2008-06-26 |
| 1649216326 | Douglas E Feeney | Urology | 925 Deis Dr, Fairfield, OH 45014-8130 | 2006-06-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326526872 | Megan Coleen Hamill | Registered Nurse | 6570 Sosna Drive, Fairfield, OH 45014 | 2018-08-06 |
| 1831695642 | James Grant Walther | Contractor | 16408 Jeanie Drive, Aurora, IN 45014 | 2018-04-02 |
| 1104339837 | Tamara Rochester | Registered Nurse | 5474 Yellowstone Dr, Fairfield, OH 45014 | 2017-11-16 |
| 1104335892 | Barbara Johnson | Registered Nurse | 2853 Saturn Drive, Fairfield, OH 45014 | 2017-09-25 |
| 1205373537 | Samuel E Ghee IIi | Counselor | Decoach Rehabilitation Center, 6570 Sosna Drive, Fairfield, OH 45014 | 2017-01-25 |
| 1669916789 | Lacretia Ancona | In Home Supportive Care | 700 Wessel Dr #181505, Fairfield, OH 45014 | 2016-12-08 |
| 1134676299 | Lynne Mutuku | Licensed Practical Nurse | 3975 Woodridge Blvd, Apt 10, Fairfield, OH 45014 | 2016-09-07 |
| 1104291020 | Mimi Supportive Hands .llc | Home Health | 6 Ridge Dr Apt 203, Cincinnati, OH 45014 | 2015-12-03 |
| 1215319181 | Brittany Beck | Social Worker | 3050 Mack Rd Ste 205, Fairfield, OH 45014 | 2015-06-26 |
| 1093193278 | Ashli Tanner | Specialist/Technologist | 8790 N. Gilmore Rd., Fairfield, OH 45014 | 2015-05-08 |
| Find all providers in zip 45014 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235435637 | John David Anderson | Urology | 4469 Green Valley Road, Fairfield, CA 94534-1365 | 2011-02-02 |
| 1073691564 | Herkanwal S. Khaira | Urology | 1860 Pennsylvania Ave Ste 200, 200, Fairfield, CA 94533-3550 | 2006-11-01 |
| 1659316487 | Mark R Howard | Urology | 7921 Jessies Way, Fairfield, OH 45011-8077 | 2006-06-17 |
| 1700820776 | Kevin G Campbell | Urology | 925 Deis Dr, Fairfield, OH 45014-8130 | 2006-06-16 |
| 1942643820 | Matthew Love | Urology | 925 Deis Dr, Fairfield, OH 45014-8130 | 2013-04-10 |
| 1356600969 | Stephen Frederick Kappa | Urology | 925 Deis Dr, Fairfield, OH 45014-8130 | 2012-05-16 |
| 1356668669 | Steven V Kardos | Urology | 425 Post Rd, 2nd Floor, Fairfield, CT 06824-6232 | 2010-04-26 |
| 1881856482 | Daniel Francis Robertshaw | Urology | 925 Deis Dr, Fairfield, OH 45014-8130 | 2008-06-26 |
| 1619134269 | Matthew S Wosnitzer | Urology | 425 Post Rd, Suite 204, Fairfield, CT 06824-6232 | 2008-05-21 |
| 1437353505 | Greater Bridgeport Urology Center PC | Urology | 425 Post Rd, 2nd Floor, Fairfield, CT 06824 | 2007-06-13 |
| Find all providers in FAIRFIELD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.