| Sjo Kids Inc | |
|
4721 Reading Rd Cincinnati OH 45237-6107 | |
| (513) 741-3100 | |
| (513) 741-5686 |
| Full Name | Sjo Kids Inc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 4721 Reading Rd, Cincinnati, Ohio |
| Authorized Official Name and Position | Eric Cummins (CEO) |
| Authorized Official Contact | 5137413100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sjo Kids Inc 4721 Reading Road Cincinnati OH 45237-6107 Ph: (513) 741-3100 | Sjo Kids Inc 4721 Reading Rd Cincinnati OH 45237-6107 Ph: (513) 741-3100 |
| NPI Number | 1689224743 |
|---|---|
| Provider Enumeration Date | 09/19/2019 |
| Last Update Date | 08/20/2024 |
| Certification Date | 08/20/2024 |
| Medicare PECOS PAC ID | 9133539604 |
|---|---|
| Medicare Enrollment ID | O20201112000614 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689224743 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Regina Woodson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730436395 PECOS PAC ID: 9133372162 Enrollment ID: I20121226000392 |
| Provider Name | Joseph A Rieman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619138724 PECOS PAC ID: 7719127703 Enrollment ID: I20130716000620 |
| Provider Name | Ann M Weber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073932026 PECOS PAC ID: 2567725799 Enrollment ID: I20180420001616 |
| Provider Name | Shantel Zwissler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538791983 PECOS PAC ID: 9133541089 Enrollment ID: I20200622002776 |
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