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2139 Auburn Ave Cincinnati OH 45219-2906 | |
| (513) 351-9900 | |
| (513) 366-4480 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 2139 Auburn Ave, Cincinnati, Ohio |
| Authorized Official Name and Position | Victor Dipilla (VP, CHIEF BUSINESS OFFICER) |
| Authorized Official Contact | 5135851295 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
2139 Auburn Ave Cincinnati OH 45219-2989 Ph: (513) 351-9900 | 2139 Auburn Ave Cincinnati OH 45219-2906 Ph: (513) 351-9900 |
| NPI Number | 1982906103 |
|---|---|
| Provider Enumeration Date | 11/19/2010 |
| Last Update Date | 01/27/2025 |
| Certification Date | 01/27/2025 |
| Medicare PECOS PAC ID | 7012197619 |
|---|---|
| Medicare Enrollment ID | O20110215000419 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982906103 | NPI | - | NPPES |
| 7100146120 | Medicaid | KY |
| Provider Name | Rebecca L Tackett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447277934 PECOS PAC ID: 9830167576 Enrollment ID: I20040921000736 |
| Provider Name | Jerry L Tolbert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144210113 PECOS PAC ID: 3072610864 Enrollment ID: I20070511000377 |
| Provider Name | Shonna H Back |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376734442 PECOS PAC ID: 6103918198 Enrollment ID: I20100722000811 |
| Provider Name | Jennifer Meyers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952614935 PECOS PAC ID: 5799809240 Enrollment ID: I20100904000012 |
| Provider Name | Monica K Sullivan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023257086 PECOS PAC ID: 0446439566 Enrollment ID: I20110121000360 |
| Provider Name | Meredith Anne Landorf |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386671410 PECOS PAC ID: 3375569676 Enrollment ID: I20120515000108 |
| Provider Name | Asha Sharma |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700183324 PECOS PAC ID: 6002055431 Enrollment ID: I20130617000078 |
| Provider Name | Laurie Ann Wallace |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033542170 PECOS PAC ID: 5092943472 Enrollment ID: I20140109001034 |
| Provider Name | Elizabeth Ann Tanner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942238019 PECOS PAC ID: 3779540729 Enrollment ID: I20150304000969 |
| Provider Name | Natalie G Lyndon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598101222 PECOS PAC ID: 0042453474 Enrollment ID: I20150915001984 |
| Provider Name | Kari Lynn Boswell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427442888 PECOS PAC ID: 9739497975 Enrollment ID: I20171108002494 |
| Provider Name | Joseph Neal Bateman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467418921 PECOS PAC ID: 8820064892 Enrollment ID: I20190108002673 |
| Provider Name | Kathleen Rebecca Feighery |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477191823 PECOS PAC ID: 8426486358 Enrollment ID: I20200306002376 |
| Provider Name | Rachel Lynn Feinauer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760918700 PECOS PAC ID: 2567731672 Enrollment ID: I20200812000935 |
| Provider Name | Maria S Rodriguez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710419817 PECOS PAC ID: 8729357827 Enrollment ID: I20200930000288 |
| Provider Name | Caitlyn Kenny |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1912352501 PECOS PAC ID: 0648562371 Enrollment ID: I20201009001188 |
| Provider Name | Kathryn Elizabeth Beaulieu |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1023479060 PECOS PAC ID: 5991097768 Enrollment ID: I20201009001477 |
| Provider Name | Jennifer Ann Fenwick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679124820 PECOS PAC ID: 1052740974 Enrollment ID: I20210528001791 |
| Provider Name | Shelby Michael Gardner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275038150 PECOS PAC ID: 3375808769 Enrollment ID: I20210802001814 |
| Provider Name | Kera Walter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689049652 PECOS PAC ID: 2365794740 Enrollment ID: I20210928002579 |
| Provider Name | Jeremy Michael Johnston |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023283835 PECOS PAC ID: 4385771443 Enrollment ID: I20220127002152 |
| Provider Name | Tamara Copeland |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457709065 PECOS PAC ID: 6800187758 Enrollment ID: I20220203002442 |
| Provider Name | Lora Danielle Ortega |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568543973 PECOS PAC ID: 4486048162 Enrollment ID: I20220222002486 |
| Provider Name | Brian Masterson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053522359 PECOS PAC ID: 4486734449 Enrollment ID: I20220602002237 |
| Provider Name | Amanda Arlington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578057907 PECOS PAC ID: 2062754492 Enrollment ID: I20220902002960 |
| Provider Name | Augusta Malin Rawlins-rader |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811556012 PECOS PAC ID: 3870823842 Enrollment ID: I20221104001513 |
| Provider Name | Mary Mann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851060057 PECOS PAC ID: 6002213311 Enrollment ID: I20230221001756 |
| Provider Name | Alisha Diane Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396404430 PECOS PAC ID: 6608260229 Enrollment ID: I20230526001621 |
| Provider Name | Devin Skylar Mccarty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043977861 PECOS PAC ID: 6103287370 Enrollment ID: I20230803003252 |
| Provider Name | Benjamin Paul Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104234970 PECOS PAC ID: 9537476684 Enrollment ID: I20230908001857 |
| Provider Name | Paige Christine Chitwood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548040397 PECOS PAC ID: 5991151243 Enrollment ID: I20231024001039 |
| Provider Name | Christopher Dearth |
|---|---|
| Provider Type | Practitioner - Other (non-physician) |
| Provider Identifiers | NPI Number: 1437880895 PECOS PAC ID: 2365823192 Enrollment ID: I20241107002419 |
| Provider Name | Denae N Butler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598059727 PECOS PAC ID: 3173849205 Enrollment ID: I20241126003775 |
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