Provider Demographics
NPI:1972593234
Name:CARDIOLOGY ASSOCIATES OF CINCINNATI, INC.
Entity type:Organization
Organization Name:CARDIOLOGY ASSOCIATES OF CINCINNATI, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DON
Authorized Official - Middle Name:
Authorized Official - Last Name:JANSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-861-1260
Mailing Address - Street 1:3219 CLIFTON AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45220-3027
Mailing Address - Country:US
Mailing Address - Phone:513-861-1260
Mailing Address - Fax:513-872-7159
Practice Address - Street 1:3219 CLIFTON AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45220-3027
Practice Address - Country:US
Practice Address - Phone:513-861-1260
Practice Address - Fax:513-872-7159
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARDIOLOGY ASSOCIATES OF CINCINNATI, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-10-26
Last Update Date:2011-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
No207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac ElectrophysiologyGroup - Single Specialty
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100028790Medicaid
KY65921611Medicaid
9179951Medicare PIN
KY65921611Medicaid
9179954Medicare PIN
9179956Medicare PIN
9179955Medicare PIN
9179957Medicare PIN
9179958Medicare PIN
9179959Medicare PIN
9179952Medicare PIN