Basic Information
Provider Information
NPI: 1811140452
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RAWLINGS
FirstName: SCOTT
MiddleName: MATTHEW
NamePrefix:  
NameSuffix:  
Credential: APRN, CNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 637783
Address2:  
City: CINCINNATI
State: OH
PostalCode: 452637783
CountryCode: US
TelephoneNumber: 5138534749
FaxNumber: 5138534740
Practice Location
Address1: 10547 MONTGOMERY RD
Address2: SUITE 400
City: MONTGOMERY
State: OH
PostalCode: 452424418
CountryCode: US
TelephoneNumber: 5137916611
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/28/2008
LastUpdateDate: 07/01/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2255A2300XAT001575OHN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
363LA2100XCOA.13772-NPOHY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care

ID Information
IDTypeStateIssuerDescription
007988105OH MEDICAID
20115233005IN MEDICAID


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