| Gerimed, Inc | |
|
4900 Cooper Rd Cincinnati OH 45242-6915 | |
| (513) 793-3362 | |
| Not Available |
| Full Name | Gerimed, Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 4900 Cooper Rd, Cincinnati, Ohio |
| Authorized Official Name and Position | Emmanuel V Rivera (OWNER) |
| Authorized Official Contact | 5135696780 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gerimed, Inc Po Box 23128 Cincinnati OH 45223-0128 Ph: (513) 891-7574 | Gerimed, Inc 4900 Cooper Rd Cincinnati OH 45242-6915 Ph: (513) 793-3362 |
| NPI Number | 1942255229 |
|---|---|
| Provider Enumeration Date | 05/24/2006 |
| Last Update Date | 08/20/2019 |
| Medicare PECOS PAC ID | 7416848445 |
|---|---|
| Medicare Enrollment ID | O20040322000263 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942255229 | NPI | - | NPPES |
| 65946352 | Medicaid | KY | |
| 2719768 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207QG0300X | Family Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
| Provider Name | Emmanuel V Rivera |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1912946146 PECOS PAC ID: 0648161695 Enrollment ID: I20040322000434 |
| Provider Name | George Kerry Knight |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144271180 PECOS PAC ID: 0941227391 Enrollment ID: I20051026000058 |
| Provider Name | Colin Quigley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689943920 PECOS PAC ID: 5496915167 Enrollment ID: I20120404000762 |
| Provider Name | Shannon Kemper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770038481 PECOS PAC ID: 5890074389 Enrollment ID: I20161128002527 |
| Provider Name | Karla J Walden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235472101 PECOS PAC ID: 5991085839 Enrollment ID: I20161209001515 |
| Provider Name | Dianna R Harrington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790172245 PECOS PAC ID: 0143599191 Enrollment ID: I20170706001721 |
| Provider Name | Ran Zhou |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467581132 PECOS PAC ID: 4981697885 Enrollment ID: I20180221000982 |
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