Individual provider Active NPI

John Louis Vertich, LCSW

  • Clinical Social Worker
  • Bradenton, FL
National Provider Identifier
1003981937
Registry record updated Sep 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW 7325 Issued in FL
Practice address
9114 58TH Dr. E,
Ste. 110
Bradenton, FL 34202
Phone
(941) 776-1777
Fax
(941) 776-2812
NPI assigned
Nov 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW 7325 FL Primary

Addresses

Primary practice location

9114 58TH Dr. E,
Ste. 110
Bradenton, FL 34202

Mailing address

9114 58TH Dr. E,
Ste. 110
Bradenton, FL 34202
Phone (941) 524-0693

Other identifiers 1

IdentifierTypeStateIssuer
767931900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW 7325FLMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410912000000",
    "number": "1003981937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9114 58TH DR. E,",
            "address_2": "STE. 110",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "34202",
            "telephone_number": "941-524-0693",
            "fax_number": "941-776-2812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9114 58TH DR. E,",
            "address_2": "STE. 110",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "34202",
            "telephone_number": "941-776-1777",
            "fax_number": "941-776-2812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERTICH",
        "first_name": "JOHN",
        "middle_name": "LOUIS",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-24",
        "last_updated": "2014-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW 7325",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "767931900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.