| Senectum Medical Group Llc | |
|
954 Sedgefield Ct Maineville OH 45039-7513 | |
| (513) 275-6551 | |
| (513) 275-6557 |
| Full Name | Senectum Medical Group Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 954 Sedgefield Ct, Maineville, Ohio |
| Authorized Official Name and Position | Phyllis Atkinson (OWNER) |
| Authorized Official Contact | 5132756551 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Senectum Medical Group Llc Po Box 1060 Uniontown OH 44685-1060 Ph: () - | Senectum Medical Group Llc 954 Sedgefield Ct Maineville OH 45039-7513 Ph: (513) 275-6551 |
| NPI Number | 1710749114 |
|---|---|
| Provider Enumeration Date | 01/30/2024 |
| Last Update Date | 01/31/2024 |
| Medicare PECOS PAC ID | 2062859994 |
|---|---|
| Medicare Enrollment ID | O20240327000783 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710749114 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QG0300X | Family Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
| 363LG0600X | Nurse Practitioner - Gerontology | (* (Not Available)) | Secondary |
| Provider Name | Phyllis J Atkinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992849509 PECOS PAC ID: 4284738121 Enrollment ID: I20070402000531 |
| Provider Name | Daniel Swagerty |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1992891048 PECOS PAC ID: 1456320555 Enrollment ID: I20170622000829 |
| Provider Name | Ran Zhou |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467581132 PECOS PAC ID: 4981697885 Enrollment ID: I20180221000982 |
Bloom Healthcare Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 954 Sedgefield Ct, Maineville, OH 45039 Phone: 970-946-4607 | |
Maineville Family Physicians Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 67 Nunner Rd., Maineville, OH 45039 Phone: 513-677-2405 Fax: 513-677-2781 |