Provider Demographics
NPI:1679514855
Name:GREATER CINCINNATI PERINATAL ASSOCIATES, LLC
Entity type:Organization
Organization Name:GREATER CINCINNATI PERINATAL ASSOCIATES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SENIOR BUSINESS ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:J
Authorized Official - Last Name:HUPRICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-245-3103
Mailing Address - Street 1:2830 VICTORY PKWY
Mailing Address - Street 2:SUITE 140
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45206-1786
Mailing Address - Country:US
Mailing Address - Phone:513-245-3113
Mailing Address - Fax:513-245-3110
Practice Address - Street 1:234 GOODMAN ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2364
Practice Address - Country:US
Practice Address - Phone:513-584-4800
Practice Address - Fax:513-584-0635
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GREATER CINCINNATI OB/GYN, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-09
Last Update Date:2008-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal MedicineGroup - Single Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
No207VC0200XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyCritical Care MedicineGroup - Single Specialty
No364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistGroup - Single Specialty
No364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult HealthGroup - Single Specialty
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2403143Medicaid
OH2571042Medicaid
OH2403116Medicaid
KY78904026Medicaid
OH2403125Medicaid
OH2403107Medicaid
OH2403134Medicaid
KY65939696Medicaid
OH2403152Medicaid
KY7702Medicare PIN
OH2403143Medicaid