| Caremed Ohio Llc | |
|
117 Jacob Parrot Rd Kenton OH 43326-9506 | |
| (718) 534-0689 | |
| Not Available |
| Full Name | Caremed Ohio Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 117 Jacob Parrot Rd, Kenton, Ohio |
| Authorized Official Name and Position | Yitty Falkowitz (DIRECTOR) |
| Authorized Official Contact | 2127346621 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Caremed Ohio Llc 65 Ramapo Valley Rd Ste 102b Mahwah NJ 07430-1100 Ph: () - | Caremed Ohio Llc 117 Jacob Parrot Rd Kenton OH 43326-9506 Ph: (718) 534-0689 |
| NPI Number | 1669123949 |
|---|---|
| Provider Enumeration Date | 01/18/2022 |
| Last Update Date | 01/19/2023 |
| Medicare PECOS PAC ID | 0547653610 |
|---|---|
| Medicare Enrollment ID | O20220214000722 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669123949 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Denise Hinders |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851672828 PECOS PAC ID: 0648445619 Enrollment ID: I20111203000037 |
| Provider Name | Angela Nichol Courtney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326438409 PECOS PAC ID: 8224354006 Enrollment ID: I20150313002040 |
| Provider Name | Tara Dillon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124405915 PECOS PAC ID: 8022322510 Enrollment ID: I20150728004854 |
| Provider Name | Jessica Madden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366824401 PECOS PAC ID: 2466769260 Enrollment ID: I20150910002091 |
| Provider Name | Kimbra Lee Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992212211 PECOS PAC ID: 5294072005 Enrollment ID: I20190131001571 |
| Provider Name | Patience Dawn Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710520788 PECOS PAC ID: 2961834353 Enrollment ID: I20191125000906 |
| Provider Name | Andrea Nicole Naegele |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972182863 PECOS PAC ID: 3577962729 Enrollment ID: I20210520002118 |
| Provider Name | Kayla Marie Morris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285371195 PECOS PAC ID: 4880078278 Enrollment ID: I20220902001998 |
| Provider Name | Gloria Vito |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124461421 PECOS PAC ID: 4486895026 Enrollment ID: I20230519000615 |
| Provider Name | Renee Lynn Korpa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952066763 PECOS PAC ID: 8820442940 Enrollment ID: I20230922003354 |
| Provider Name | Lilian Mugwede |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629580196 PECOS PAC ID: 6002198611 Enrollment ID: I20231009000995 |
| Provider Name | Andrew J King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205695020 PECOS PAC ID: 6507205101 Enrollment ID: I20240416001136 |
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