| Beckett Springs Physician Group Llc | |
|
8614 Shepherd Farm Dr West Chester OH 45069-1128 | |
| (513) 942-9500 | |
| (513) 714-7374 |
| Full Name | Beckett Springs Physician Group Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 8614 Shepherd Farm Dr, West Chester, Ohio |
| Authorized Official Name and Position | Gina Warren (DIRECTOR CREDENTIALING & PAYOR ENRO) |
| Authorized Official Contact | 5024008480 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Beckett Springs Physician Group Llc 8614 Shepherd Farm Dr West Chester OH 45069-1128 Ph: (513) 942-9500 | Beckett Springs Physician Group Llc 8614 Shepherd Farm Dr West Chester OH 45069-1128 Ph: (513) 942-9500 |
| NPI Number | 1285045922 |
|---|---|
| Provider Enumeration Date | 05/15/2014 |
| Last Update Date | 10/11/2021 |
| Certification Date | 10/11/2021 |
| Medicare PECOS PAC ID | 1951624097 |
|---|---|
| Medicare Enrollment ID | O20141222002571 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285045922 | NPI | - | NPPES |
| 0103989 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
| Provider Name | Anne M Miller |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871557769 PECOS PAC ID: 5496738122 Enrollment ID: I20040614000065 |
| Provider Name | Mohamed A Abdel Aziz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1760489421 PECOS PAC ID: 5395703243 Enrollment ID: I20051115000648 |
| Provider Name | Dipika J Shah |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316939937 PECOS PAC ID: 7416952403 Enrollment ID: I20060926000357 |
| Provider Name | Kenneth David Senser |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1609875269 PECOS PAC ID: 3971678012 Enrollment ID: I20080825000142 |
| Provider Name | Elizabeth L Schmitt |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194990259 PECOS PAC ID: 1153581541 Enrollment ID: I20120321000810 |
| Provider Name | Rebecca L Al-hamdani |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407113442 PECOS PAC ID: 6406098813 Enrollment ID: I20130814001030 |
| Provider Name | Chole Mullen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528023975 PECOS PAC ID: 9830383553 Enrollment ID: I20140423001383 |
| Provider Name | Carlos O Andarsio |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487846945 PECOS PAC ID: 4385682301 Enrollment ID: I20141219001629 |
| Provider Name | Gurkiran Gill |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194967216 PECOS PAC ID: 9931425915 Enrollment ID: I20170209001602 |
| Provider Name | Princess G Gaitawe Johnson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699936377 PECOS PAC ID: 1850529405 Enrollment ID: I20170327002756 |
| Provider Name | Christa S Bryant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043661200 PECOS PAC ID: 2163704867 Enrollment ID: I20170523002948 |
| Provider Name | Julia A Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619100500 PECOS PAC ID: 1052467883 Enrollment ID: I20171213002028 |
| Provider Name | Xixi Wong |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174815997 PECOS PAC ID: 0648560607 Enrollment ID: I20180207001042 |
| Provider Name | Kenneth Richmond |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184891277 PECOS PAC ID: 6608015342 Enrollment ID: I20180613002059 |
| Provider Name | Lonna Larger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629555321 PECOS PAC ID: 9931445905 Enrollment ID: I20190111001530 |
| Provider Name | Joanna Wade |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023482627 PECOS PAC ID: 3173826013 Enrollment ID: I20190703001457 |
| Provider Name | Jamie A Fields |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235794439 PECOS PAC ID: 6002142627 Enrollment ID: I20190719000822 |
| Provider Name | Tiffonie Lynn Caudill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699373696 PECOS PAC ID: 1557773199 Enrollment ID: I20201223001687 |
| Provider Name | Lori R Morgan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902495195 PECOS PAC ID: 3870908874 Enrollment ID: I20210225002221 |
| Provider Name | Anne Bohardt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023731890 PECOS PAC ID: 0143698662 Enrollment ID: I20221115000326 |
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