UNIVERSITY INTERNAL MEDICINE ASSOCIATES, INC.

Provider Demographics

• NPI: 1588620850
• Name: UNIVERSITY INTERNAL MEDICINE ASSOCIATES, INC.
• Entity Type: Organization
• Organization Name: UNIVERSITY INTERNAL MEDICINE ASSOCIATES, INC.
• Authorized Official - Title/Position: EXECUTIVE DIRECTOR
• Authorized Official - First Name: TIPTON
• Authorized Official - Last Name: FORD
• Authorized Official - Phone: 513-558-4231
• Mailing Address - Street 1: 2830 VICTORY PKWY
• Mailing Address - Street 2: CENTRAL CREDENTIALING
• Mailing Address - City: CINCINNATI
• Mailing Address - State: OH
• Mailing Address - Zip Code: 45206-1785
• Mailing Address - Country: US
• Mailing Address - Phone: 513-245-3431
• Mailing Address - Fax: 513-475-7259
• Practice Address - Street 1: 222 PIEDMONT AVE
• Practice Address - Street 2: STE 6000
• Practice Address - City: CINCINNATI
• Practice Address - State: OH
• Practice Address - Zip Code: 45219-4231
• Practice Address - Country: US
• Practice Address - Phone: 513-245-3600
• Practice Address - Fax: 513-245-3672
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2006-04-25
• Last Update Date: 2011-01-03

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization	Group
Yes	207R00000X	Allopathic & Osteopathic Physicians	Internal Medicine		Group - Multi-Specialty
No	207RA0201X	Allopathic & Osteopathic Physicians	Internal Medicine	Allergy & Immunology	Group - Multi-Specialty
No	207RC0000X	Allopathic & Osteopathic Physicians	Internal Medicine	Cardiovascular Disease	Group - Multi-Specialty
No	207RE0101X	Allopathic & Osteopathic Physicians	Internal Medicine	Endocrinology, Diabetes & Metabolism	Group - Multi-Specialty
No	207RG0100X	Allopathic & Osteopathic Physicians	Internal Medicine	Gastroenterology	Group - Multi-Specialty
No	207RH0003X	Allopathic & Osteopathic Physicians	Internal Medicine	Hematology & Oncology	Group - Multi-Specialty
No	207RI0001X	Allopathic & Osteopathic Physicians	Internal Medicine	Clinical & Laboratory Immunology	Group - Multi-Specialty
No	207RI0011X	Allopathic & Osteopathic Physicians	Internal Medicine	Interventional Cardiology	Group - Multi-Specialty
No	207RI0200X	Allopathic & Osteopathic Physicians	Internal Medicine	Infectious Disease	Group - Multi-Specialty
No	207RN0300X	Allopathic & Osteopathic Physicians	Internal Medicine	Nephrology	Group - Multi-Specialty
No	207RP1001X	Allopathic & Osteopathic Physicians	Internal Medicine	Pulmonary Disease	Group - Multi-Specialty
No	207RR0500X	Allopathic & Osteopathic Physicians	Internal Medicine	Rheumatology	Group - Multi-Specialty
No	207RX0202X	Allopathic & Osteopathic Physicians	Internal Medicine	Medical Oncology	Group - Multi-Specialty
No	363A00000X	Physician Assistants & Advanced Practice Nursing Providers	Physician Assistant		Group - Multi-Specialty
No	363L00000X	Physician Assistants & Advanced Practice Nursing Providers	Nurse Practitioner		Group - Multi-Specialty

Provider Identifiers

State	Identifier ID	ID Type	Issuer
OH	CF8930	Other	RAIL ROAD MEDICARE
OH	2445116	Medicaid
OH	CC3432	Other	RAIL ROAD MEDICARE
OH	CD4194	Other	RAIL ROAD MEDICARE
KY	78902558	Medicaid
OH	CN4337	Other	RAIL ROAD MEDICARE
OH	CH9791	Other	RAILROAD MEDICARE
IN	100094000	Medicaid
OH	CB4920	Other	RAIL ROAD MEDICARE
IN	200430710	Medicaid
KY	65906893	Medicaid
KY	95901161	Medicaid
KY	9215	Medicare PIN
KY	7222	Medicare PIN
KY	6665	Medicare PIN
KY	7223	Medicare PIN
OH	UN9158853	Medicare PIN
OH	CD4194	Other	RAIL ROAD MEDICARE
OH	CN4337	Other	RAIL ROAD MEDICARE
KY	95901161	Medicaid
KY	7220	Medicare PIN