MEDICARE: DR. SARAH ELLEN MCCORMACK SPIVEY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	35.147171	OH
2	2080P0207X	Pediatric Hematology & Oncology Physician	35.147171	OH

General Provider Information

NPI Number	:	1548897838
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SARAH ELLEN MCCORMACK SPIVEY MD

Provider Business Mailing Address
First Line	:	3333 BURNET AVENUE
Second Line	:	MLC 7015
City	:	CINCINNATI
State	:	OH
Zip	:	45229
Country	:	US
Telephone Number	:	513-636-4315
Fax Number	:

Provider Business Practice Location Address
First Line	:	3333 BURNET AVENUE
Second Line	:	MLC 5018
City	:	CINCINNATI
State	:	OH
Zip	:	45229
Country	:	US
Telephone Number	:	513-636-4315
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/25/2020
Last Update Date	:	06/29/2026

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