LIBERTY SHARONVILLE PEDIATRICS (NPI# 1356409718) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356409718 |
| Entity Type | Organization |
| Organization Name | LIBERTY SHARONVILLE PEDIATRICS |
| Practice Address |
11258 Lebanon Rd Cincinnati OH 45241-2214 |
| Practice Telephone | 5135630044 |
| Practice Fax Number | 5135630061 |
| Mailing Telephone | 5135630044 |
| Mailing Fax Number | 5135630061 |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2015-03-26 |
| Authorized Official Name | DR. STEVEN R BRINN (PHYSICIAN) |
| Authorized Official Telephone | 5135630044 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 040823 | OH | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | ANTHEM BCBS | 000000016767 | 01 |
| HI | 0912570 | 05 |
| Street Address |
11258 LEBANON RD |
| City | CINCINNATI |
| State | OH |
| Zip Code | 45241-2214 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639164924 | Steven R. Brinn | Pediatrics | 11258 Lebanon Rd, Cincinnati, OH 45241-2214 | 2005-09-13 |
| 1033505292 | Beverley Phillips | Pediatrics | 11258 Lebanon Rd, Cincinnati, OH 45241 | 2015-04-14 |
| 1548255839 | Otilia P. Fernandez | Pediatrics | 11258 Lebanon Rd, Cincinnati, OH 45241-2214 | 2005-09-13 |
| 1073508362 | Lauren A Peck | Pediatrics | 11258 Lebanon Rd, Cincinnati, OH 45241-2214 | 2005-09-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891348512 | Ultimate Rehab, Ltd. | Physical Therapy Assistant | 11305 Reed Hartman Hwy., Ste. 226, Cincinnati, OH 45241 | 2019-07-22 |
| 1548787682 | Brian Eversole | Community Health Worker | 11156 Canal Road, #a, Cincinnati, OH 45241 | 2017-08-29 |
| 1013464544 | Emily Niehaus | Specialist/Technologist | 10040 Bennington Drive, Cincinnati, OH 45241 | 2016-09-01 |
| 1003274523 | Samuel Cogen | Specialist/Technologist | 4480 Classic Dr, Blue Ash, OH 45241 | 2016-01-29 |
| 1023420940 | Suzette Kies | Physical Therapist | 3900 Cottingham Drive, Princeton City Schools, Cincinnati, OH 45241 | 2014-05-27 |
| 1457770703 | Timothy Craig Wylie | Podiatrist | 10475 Reading Rd Ste 308, Cincinnati, OH 45241 | 2014-04-15 |
| 1295150027 | Lisa Brackmann | Speech-Language Pathologist | 11150 Maple Avenue, Cincinnati, Ohio, OH 45241 | 2014-03-04 |
| 1740602416 | Karyn Bransford | Nurse Anesthetist, Certified Registered | 9306 Brandy Wine Ln, West Chester, OH 45241 | 2014-01-14 |
| 1144586868 | Nichole Sherrie Hickman | Counselor | 300 E Business Way Ste 200, Cincinnati, OH 45241 | 2012-04-06 |
| 1497044846 | Garrett Alexander Seghi | Dentist | 11438 Lebanon Pike (rt.42), Suite # F, Cincinnati, OH 45241 | 2011-04-06 |
| Find all providers in zip 45241 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710595327 | Katelyn Marie Gurren | Specialist | 5050 Madison Rd # N, Cincinnati, OH 45227-1491 | 2020-07-20 |
| 1497224398 | Kimberly Wayne Bolden | Specialist | 5560 Edger Dr, Cincinnati, OH 45239-7293 | 2018-11-20 |
| 1285153262 | Philip Jason Jemison I | Specialist | 5050 Madison Road, Cincinnati, OH 45227 | 2017-09-12 |
| 1720520612 | Westside Primary Care, LLC | Specialist | 4342 Harrison Ave, Cincinnati, OH 45211-3322 | 2016-11-09 |
| 1710439427 | Mayo Tamura | Specialist | 8 Enfield St, Cincinnati, OH 45218-1434 | 2016-10-28 |
| 1336696301 | Tyler Matthew Wynn | Specialist | 151 W Galbraith Rd Ste N2045, Cincinnati, OH 45216-1015 | 2016-09-07 |
| 1508220047 | Kenneth Gans | Specialist | 1112 Fenmore Dr, Cincinnati, OH 45237-5120 | 2016-04-11 |
| 1922469303 | Emily Maue | Specialist | 5014 Madison Rd, Apt 5, Cincinnati, OH 45227-1432 | 2016-03-14 |
| 1598162109 | Melissa Hudson | Specialist | 11770 Pippin Rd, Cincinnati, OH 45231-1158 | 2014-11-25 |
| 1336555481 | Steven Spreen | Specialist | 6814 Miami Bluff Dr, Cincinnati, OH 45227-4313 | 2014-07-09 |
| Find all providers in CINCINNATI | ||||
| City | CINCINNATI |
| Zip Code | 45241 |
Please comment or provide details below to improve the information on LIBERTY SHARONVILLE PEDIATRICS.
| 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.