Provider Demographics
NPI:1396708483
Name:HARVEY, JODI MICHELLE (MD)
Entity type:Individual
Prefix:DR
First Name:JODI
Middle Name:MICHELLE
Last Name:HARVEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4685 FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45212-3397
Mailing Address - Country:US
Mailing Address - Phone:513-774-8512
Mailing Address - Fax:513-645-9750
Practice Address - Street 1:10675A LOVELAND-MADEIRA RD
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:OH
Practice Address - Zip Code:45140-8965
Practice Address - Country:US
Practice Address - Phone:513-774-8512
Practice Address - Fax:513-645-9750
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.092979207R00000X
KY38773207RA0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RA0000XAllopathic & Osteopathic PhysiciansInternal MedicineAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2932072Medicaid
OH2932072Medicaid
OHP00915556Medicare PIN
KYI16335Medicare UPIN
OHHA4261722Medicare PIN
KY0673504Medicare PIN
OHHA4261721Medicare PIN