Basic Information
Provider Information
NPI: 1225092224
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHNEIDER
FirstName: JOHN
MiddleName: F
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 237 WILLIAM HOWARD TAFT RD
Address2: 2ND FLOOR, CBO 2-3
City: CINCINNATI
State: OH
PostalCode: 452192610
CountryCode: US
TelephoneNumber: 5139850022
FaxNumber: 5139850088
Practice Location
Address1: 11140 MONTGOMERY RD
Address2:  
City: CINCINNATI
State: OH
PostalCode: 452492309
CountryCode: US
TelephoneNumber: 5137927800
FaxNumber: 5137927807
Other Information
ProviderEnumerationDate: 04/14/2006
LastUpdateDate: 10/22/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/22/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0000X35044988OHN Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
207RI0011X35.044988OHY Allopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology

ID Information
IDTypeStateIssuerDescription
048651305OH MEDICAID
31143887106601 CARESOURCEOTHER
065500501 AETNAOTHER
20007000005IN MEDICAID
00000021516501 ANTHEMOTHER
252038201 UNITED HEALTHCAREOTHER
28390601 AMERIGROUPOTHER
44988801 HUMANAOTHER
6478395405KY MEDICAID


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