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General NPI Number Information
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NPI Number | 1609915784
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Entity Type | Organization
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Legal Business Name | CHILDREN'S HOSPITAL MEDICAL CENTER
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 3333 BURNET AVENUE
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City | CINCINNATI
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State | OH
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Zip | 45229-3039
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Country | US
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Telephone | 513-636-4225
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Fax | 513-636-2511
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Provider Business Mailing Address
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Address Line | 3333 BURNET AVENUE MAIL LOCATION 5021
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City | CINCINNATI
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State | OH
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Zip | 45229-3026
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Country | US
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Telephone | 513-636-4225
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Fax | 513-636-2511
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Authorized Official
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Title or Position | SR. DIRECTOR MEDICAL STAFF SERVICES
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Name | KIMBERLY GIVENS
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Credential |
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Telephone | 513-636-6977
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 207LP3000X
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Taxonomy Name | Pediatric Anesthesiology Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 152WP0200X
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Taxonomy Name | Pediatric Optometrist
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 364S00000X
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Taxonomy Name | Clinical Nurse Specialist
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #12
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #13
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number |
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License Number State |
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Taxonomy #14
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number |
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License Number State |
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Taxonomy #15
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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=====================================================
Legacy Identifiers
=====================================================
Identifier #1
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Identifier Code | 0307822
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Identifier Type | MEDICAID
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Identifier State | OH
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Identifier Issuer |
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Identifier #2
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Identifier Code | 02757106
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Identifier Type | MEDICAID
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Identifier State | NY
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Identifier Issuer |
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Identifier #3
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Identifier Code | 0738674
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Identifier Type | MEDICAID
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Identifier State | IA
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Identifier Issuer |
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Identifier #4
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Identifier Code | 77903474
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Identifier Type | MEDICAID
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Identifier State | KY
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Identifier Issuer |
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Identifier #5
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Identifier Code | QPA814
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Identifier Type | MEDICAID
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Identifier State | SC
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Identifier Issuer |
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Identifier #6
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Identifier Code | 100280240C
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Identifier Type | MEDICAID
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Identifier State | KS
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Identifier Issuer |
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Identifier #7
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Identifier Code | 117749401
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Identifier Type | MEDICAID
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Identifier State | WY
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Identifier Issuer |
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Identifier #8
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Identifier Code | 78904349
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Identifier Type | MEDICAID
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Identifier State | KY
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Identifier Issuer |
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Identifier #9
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Identifier Code | 001065780-0005
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Identifier Type | MEDICAID
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Identifier State | PA
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Identifier Issuer |
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Identifier #10
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Identifier Code | 100690580B
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Identifier Type | MEDICAID
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Identifier State | OK
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Identifier Issuer |
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Identifier #11
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Identifier Code | 1172363
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Identifier Type | OTHER
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Identifier State | KY
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Identifier Issuer | PASSPORT (NEONATAL)
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Identifier #12
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Identifier Code | 119659404
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Identifier Type | MEDICAID
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Identifier State | TX
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Identifier Issuer |
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Identifier #13
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Identifier Code | 65823524
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Identifier Type | MEDICAID
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Identifier State | CO
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Identifier Issuer |
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Identifier #14
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Identifier Code | 65901886
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Identifier Type | MEDICAID
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Identifier State | KY
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Identifier Issuer |
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Identifier #15
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Identifier Code | 001065780-0006
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Identifier Type | MEDICAID
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Identifier State | PA
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Identifier Issuer |
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Identifier #16
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Identifier Code | 100012670A
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Identifier Type | MEDICAID
-----------------------------------------------------
Identifier State | IN
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Identifier Issuer |
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Identifier #17
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Identifier Code | 8674809
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Identifier Type | MEDICAID
-----------------------------------------------------
Identifier State | NJ
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Identifier Issuer |
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Identifier #18
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Identifier Code | 0001846001
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Identifier Type | MEDICAID
-----------------------------------------------------
Identifier State | WV
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Identifier Issuer |
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Identifier #19
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Identifier Code | 108749800
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Identifier Type | MEDICAID
-----------------------------------------------------
Identifier State | FL
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Identifier Issuer |
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Identifier #20
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Identifier Code | 1172052
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Identifier Type | OTHER
-----------------------------------------------------
Identifier State | KY
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Identifier Issuer | PASSPORT
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Identifier #21
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Identifier Code | 95901138
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Identifier Type | MEDICAID
-----------------------------------------------------
Identifier State | KY
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Identifier Issuer |
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Identifier #22
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Identifier Code | 108749800
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Identifier Type | MEDICAID
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Identifier State | FL
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Identifier Issuer | Florida Medicaid Provider ID
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=====================================================
Proprietary Identifiers Ever Reported
=====================================================
Identifier #1
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Identifier Code | 0001846001
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Identifier Type | MEDICAID
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Identifier State | WV
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Identifier Issuer |
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Identifier #2
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Identifier Code | 001065780-0005
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Identifier Type | MEDICAID
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Identifier State | PA
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Identifier Issuer |
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Identifier #3
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Identifier Code | 001065780-0006
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Identifier Type | MEDICAID
-----------------------------------------------------
Identifier State | PA
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Identifier Issuer |
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Identifier #4
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Identifier Code | 02757106
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Identifier Type | MEDICAID
-----------------------------------------------------
Identifier State | NY
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Identifier Issuer |
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Identifier #5
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Identifier Code | 0307822
-----------------------------------------------------
Identifier Type | MEDICAID
-----------------------------------------------------
Identifier State | OH
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Identifier Issuer |
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Identifier #6
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Identifier Code | 0738674
-----------------------------------------------------
Identifier Type | MEDICAID
-----------------------------------------------------
Identifier State | IA
-----------------------------------------------------
Identifier Issuer |
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Identifier #7
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Identifier Code | 100012670A
-----------------------------------------------------
Identifier Type | MEDICAID
-----------------------------------------------------
Identifier State | IN
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Identifier Issuer |
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Identifier #8
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Identifier Code | 100280240C
-----------------------------------------------------
Identifier Type | MEDICAID
-----------------------------------------------------
Identifier State | KS
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Identifier Issuer |
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Identifier #9
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Identifier Code | 100690580B
-----------------------------------------------------
Identifier Type | MEDICAID
-----------------------------------------------------
Identifier State | OK
-----------------------------------------------------
Identifier Issuer |
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Identifier #10
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Identifier Code | 108749800
-----------------------------------------------------
Identifier Type | MEDICAID
-----------------------------------------------------
Identifier State | FL
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Identifier Issuer |
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Identifier #11
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Identifier Code | 108749800
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Identifier Type | MEDICAID
-----------------------------------------------------
Identifier State | FL
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Identifier Issuer | Florida Medicaid Provider ID
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Identifier #12
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Identifier Code | 1172052
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Identifier Type | OTHER
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Identifier State | KY
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Identifier Issuer | PASSPORT
-----------------------------------------------------
Identifier #13
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Identifier Code | 1172363
-----------------------------------------------------
Identifier Type | OTHER
-----------------------------------------------------
Identifier State | KY
-----------------------------------------------------
Identifier Issuer | PASSPORT (NEONATAL)
-----------------------------------------------------
Identifier #14
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Identifier Code | 117749401
-----------------------------------------------------
Identifier Type | MEDICAID
-----------------------------------------------------
Identifier State | WY
-----------------------------------------------------
Identifier Issuer |
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Identifier #15
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Identifier Code | 119659404
-----------------------------------------------------
Identifier Type | MEDICAID
-----------------------------------------------------
Identifier State | TX
-----------------------------------------------------
Identifier Issuer |
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Identifier #16
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Identifier Code | 65823524
-----------------------------------------------------
Identifier Type | MEDICAID
-----------------------------------------------------
Identifier State | CO
-----------------------------------------------------
Identifier Issuer |
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Identifier #17
-----------------------------------------------------
Identifier Code | 65901886
-----------------------------------------------------
Identifier Type | MEDICAID
-----------------------------------------------------
Identifier State | KY
-----------------------------------------------------
Identifier Issuer |
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Identifier #18
-----------------------------------------------------
Identifier Code | 77903474
-----------------------------------------------------
Identifier Type | MEDICAID
-----------------------------------------------------
Identifier State | KY
-----------------------------------------------------
Identifier Issuer |
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Identifier #19
-----------------------------------------------------
Identifier Code | 78904349
-----------------------------------------------------
Identifier Type | MEDICAID
-----------------------------------------------------
Identifier State | KY
-----------------------------------------------------
Identifier Issuer |
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Identifier #20
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Identifier Code | 8674809
-----------------------------------------------------
Identifier Type | MEDICAID
-----------------------------------------------------
Identifier State | NJ
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Identifier Issuer |
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Identifier #21
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Identifier Code | 909895000
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Identifier Type | MEDICAID
-----------------------------------------------------
Identifier State | FL
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Identifier Issuer |
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Identifier #22
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Identifier Code | 95901138
-----------------------------------------------------
Identifier Type | MEDICAID
-----------------------------------------------------
Identifier State | KY
-----------------------------------------------------
Identifier Issuer |
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Identifier #23
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Identifier Code | QPA814
-----------------------------------------------------
Identifier Type | MEDICAID
-----------------------------------------------------
Identifier State | SC
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Identifier Issuer |
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