CINCINNATI PET SCAN, LLC (NPI# 1386757896) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386757896 |
| Entity Type | Organization |
| Organization Name | CINCINNATI PET SCAN, LLC |
| Practice Address |
4777 E Galbraith Rd 1st Floor Cincinnati OH 45236-2725 |
| Mailing Address |
5053 Wooster Rd Cincinnati OH 45226-2326 |
| Practice Telephone | 5137919959 |
| Practice Fax Number | 5137919958 |
| Mailing Telephone | 5137512145 |
| Mailing Fax Number | 5137512138 |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2012-08-23 |
| Authorized Official Name | JOHN MATTES (PRESIDENT) |
| Authorized Official Telephone | 5137919959 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0200X |
Clinic/Center Specialization: Radiology |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200348290A | 05 | |
| KY | 86000189 | 05 | |
| OH | 2265865 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063525582 | Cincinnati Pet Scan, LLC | Clinic/Center | 5575 Cheviot Road, Monfort Heights, Cincinnati, OH 45247 | 2006-08-17 |
| 1023195088 | Cincinnati Pet Scan, LLC | Clinic/Center | 651 Centre View Blvd, 110, Crestview Hills, KY 41017-5423 | 2006-11-01 |
| 1851407217 | Cincinnati Pet Scan, LLC | Clinic/Center | 5575 Cheviot Road, Westside Ct Center, Cincinnati, OH 45247 | 2006-08-21 |
| 1740224419 | Cincinnati Pet Scan, LLC | Clinic/Center | 651 Centre View Blvd, Cresview Hills, KY 41017 | 2006-06-15 |
| Street Address |
4777 E GALBRAITH RD 1ST FLOOR |
| City | CINCINNATI |
| State | OH |
| Zip Code | 45236-2725 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760488993 | Stephen J Goldberg | Internal Medicine | 4777 E Galbraith Rd, Cincinnati, OH 45236-2725 | 2005-06-22 |
| 1699382572 | Mary Kreimer | Nurse Practitioner | 4777 E Galbraith Rd, Cincinnati, OH 45236-2814 | 2020-09-25 |
| 1922617448 | Shuja Rizvi | Student in an Organized Health Care Education/Training Program | 4777 E Galbraith Rd, Cincinnati, OH 45236-2725 | 2020-07-30 |
| 1114547288 | Paige Waugh | Pharmacist | 4777 E Galbraith Rd, Cincinnati, OH 45236-2725 | 2020-04-19 |
| 1679192645 | Timothy Berg | Student in an Organized Health Care Education/Training Program | 4777 E Galbraith Rd, Cincinnati, OH 45236-2725 | 2020-04-10 |
| 1245869486 | Joseph Wilding | Student in an Organized Health Care Education/Training Program | 4777 E Galbraith Rd, Cincinnati, OH 45236-2725 | 2020-04-08 |
| 1932738598 | Faridoon Wahid | Student in an Organized Health Care Education/Training Program | 4777 E Galbraith Rd, Cincinnati, OH 45236-2725 | 2020-04-06 |
| 1972132736 | Austin David Jorski | Student in an Organized Health Care Education/Training Program | 4777 E Galbraith Rd, Cincinnati, OH 45236-2814 | 2020-04-03 |
| 1720617541 | Elizabeth Nicole Klein | Student in an Organized Health Care Education/Training Program | 4777 E Galbraith Rd, Cincinnati, OH 45236-2814 | 2020-04-03 |
| 1538798525 | Kofi Ansah | Student in an Organized Health Care Education/Training Program | 4777 E Galbraith Rd, Cincinnati, OH 45236-2725 | 2020-04-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700400975 | Kimberly Lorraine Carter | Technician | 3870 Alta Avenue, # 1, Cincinnati, OH 45236 | 2020-06-03 |
| 1548880032 | Manu Jacob George | Student in an Organized Health Care Education/Training Program | 4777 East Galbraith Road The Jewish Hospital, Cincinnati, OH 45236 | 2020-04-24 |
| 1497384374 | Haider Hussain Shah | Student in an Organized Health Care Education/Training Program | 4777 E. Galbraith Road, The Jewish Hospital, Cincinnati, OH 45236 | 2020-04-03 |
| 1467091868 | Wickshire Deer Park Opco LLC | Assisted Living Facility | 3801 East Galbraith Road, Cincinnati, OH 45236 | 2020-01-02 |
| 1205497633 | Nicholas Theodore D'entremont | Student in an Organized Health Care Education/Training Program | 4777 E. Galbraith Street - Jewish Hospital, Cincinnati, OH 45236 | 2019-06-26 |
| 1407410699 | Atchayaa Gunasekharan | Student in an Organized Health Care Education/Training Program | 4777 East Galbraith Road, Cincinnati, OH 45236 | 2019-04-24 |
| 1225591043 | Lauren Elizabeth Hamilton | Student in an Organized Health Care Education/Training Program | 4777 East Galbraith Rd, Cincinnati, OH 45236 | 2019-04-09 |
| 1972093714 | Hassan Shafique | Student in an Organized Health Care Education/Training Program | 4777 E Galbraith, Cincinnati, OH 45236 | 2018-05-17 |
| 1912494915 | Milica Antic | Student in an Organized Health Care Education/Training Program | The Jewish Hospital, 4777 East Galbraith Rd, Cincinnati, OH 45236 | 2018-04-16 |
| 1376041061 | Angela Eten | Nurse Practitioner | 4700 E Galbraith Rd Ste 301, Cincinnati, OH 45236 | 2018-01-27 |
| Find all providers in zip 45236 | ||||
| Taxonomy Code | 261QR0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Radiology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225507551 | Imaging Support Services Inc | Clinic/Center | 4244 Aicholtz Road Suite D, Cincinnati, OH 45245 | 2018-11-15 |
| 1710417605 | B&d Radiology Partners Pllc | Clinic/Center | 452 Ashsteade Ln, Cincinnati, OH 45255-3710 | 2017-06-14 |
| 1649318643 | Evendale Ancillary Services, LLC | Clinic/Center | 3147 Glendale Milford Road, Cincinnati, OH 45241 | 2007-02-02 |
| 1063525582 | Cincinnati Pet Scan, LLC | Clinic/Center | 5575 Cheviot Road, Monfort Heights, Cincinnati, OH 45247 | 2006-08-17 |
| 1194778654 | Advanced Diagnostics | Clinic/Center | 8074 Beechmont Ave, Cincinnati, OH 45255-5108 | 2006-05-18 |
| 1851407217 | Cincinnati Pet Scan, LLC | Clinic/Center | 5575 Cheviot Road, Westside Ct Center, Cincinnati, OH 45247 | 2006-08-21 |
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|---|---|---|---|---|
| 1073121521 | Executive Imaging, LLC | Clinic/Center | 1069 Delaware Ave Ste 104, Marion, OH 43302-6459 | 2020-07-21 |
| 1912532904 | Northern Ohio Medical Specialists, LLC | Clinic/Center | 26151 Euclid Ave Ste 130, Euclid, OH 44132-3300 | 2020-03-10 |
| 1326510868 | Genetesis, Inc. | Clinic/Center | 5412 Courseview Dr Ste 150, Mason, OH 45040-2483 | 2018-12-21 |
| 1235671710 | Citran Xray LLC | Clinic/Center | 7774 Dayton Springfield Road, Fairborn, OH 45324-1996 | 2016-11-15 |
| 1598163164 | Fostoria Hospital Association | Clinic/Center | 455 W 4th St Ste 30, Fostoria, OH 44830-1864 | 2014-12-15 |
| 1487991360 | Birchcrest Holdings, LLC | Clinic/Center | 19250 Bagley Rd Ste 202, Cleveland, OH 44130 | 2013-01-11 |
| 1487922548 | Northern Ohio Medical Specialists, LLC | Clinic/Center | 2800 Hayes Ave # Bdlgc130, Sandusky, OH 44870 | 2011-12-05 |
| 1164726360 | Birchcrest Holdings, LLC | Clinic/Center | 4760 Richmond Rd Ste 300, Cleveland, OH 44128 | 2011-01-03 |
| 1215170824 | Value Added Imaging Services, LLC | Clinic/Center | 5192 Chillicothe Rd Ste 102, Chagrin Falls, OH 44022-4196 | 2009-04-13 |
| 1114103504 | Vital Scan of Central Ohio | Clinic/Center | 5747 Perimeter Dr., Ste 105, Dublin, OH 43017 | 2008-01-15 |
| Find all providers with the same taxonomy | ||||
| City | CINCINNATI |
| Zip Code | 45236 |
Please comment or provide details below to improve the information on CINCINNATI PET SCAN, LLC.
| 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.