| St. Joseph Orphanage | |
|
5400 Edalbert Dr Cincinnati OH 45239-7604 | |
| (513) 741-3100 | |
| (513) 741-5686 |
| Full Name | St. Joseph Orphanage |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 5400 Edalbert Dr, Cincinnati, Ohio |
| Authorized Official Name and Position | Eric Cummins (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5137413100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| St. Joseph Orphanage 5400 Edalbert Dr Cincinnati OH 45239-7604 Ph: (513) 741-3100 | St. Joseph Orphanage 5400 Edalbert Dr Cincinnati OH 45239-7604 Ph: (513) 741-3100 |
| NPI Number | 1194882092 |
|---|---|
| Provider Enumeration Date | 01/02/2007 |
| Last Update Date | 08/11/2014 |
| Medicare PECOS PAC ID | 5890081665 |
|---|---|
| Medicare Enrollment ID | O20160902000036 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194882092 | NPI | - | NPPES |
| 2531960 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 219 (Ohio) | Primary |
| Provider Name | Mary A Jaffe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497082903 PECOS PAC ID: 3072653187 Enrollment ID: I20091222000358 |
| Provider Name | Regina Woodson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730436395 PECOS PAC ID: 9133372162 Enrollment ID: I20121226000392 |
| Provider Name | Rose Marie Pryor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245281203 PECOS PAC ID: 4284644691 Enrollment ID: I20130214000287 |
| Provider Name | Joseph A Rieman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619138724 PECOS PAC ID: 7719127703 Enrollment ID: I20130716000620 |
| Provider Name | Epie L Ajebe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861729071 PECOS PAC ID: 3072745413 Enrollment ID: I20140416002513 |
| Provider Name | Lindsay R Bergman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710197173 PECOS PAC ID: 5496075376 Enrollment ID: I20150515001254 |
| Provider Name | April Abaecherli-shore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881060267 PECOS PAC ID: 4284938390 Enrollment ID: I20160210002336 |
| Provider Name | Maryellen Smolenski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255673257 PECOS PAC ID: 7810283587 Enrollment ID: I20160906001558 |
| Provider Name | Krista D Porterfield Spurling |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073713129 PECOS PAC ID: 3678861242 Enrollment ID: I20161013002644 |
| Provider Name | Jasmine N Shafto |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336177856 PECOS PAC ID: 1951678440 Enrollment ID: I20170605002459 |
| Provider Name | Ann M Weber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073932026 PECOS PAC ID: 2567725799 Enrollment ID: I20180420001616 |
| Provider Name | Shantel Zwissler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538791983 PECOS PAC ID: 9133541089 Enrollment ID: I20200622002776 |
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