MEDICARE: CINCINNATI CHILDREN'S HOSPITAL

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	207LP3000X	Pediatric Anesthesiology Physician

General Provider Information

NPI Number	:	1558249292
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CINCINNATI CHILDREN'S HOSPITAL

Provider Business Mailing Address
First Line	:	3333 BURNET AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45229-3026
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3333 BURNET AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45229-3026
Country	:	US
Telephone Number	:	855-422-8894
Fax Number	:

Authorized Official
Title or Position	:	ENROLLMENT COORDINATOR
Name	:	JENNY PHILLIPS
Credential	:
Telephone Number	:	513-636-4225

Provider Enumeration Date	:	08/21/2025
Last Update Date	:	12/31/2025

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Directions to “CINCINNATI CHILDREN'S HOSPITAL ” Practice Location

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