Individual provider Active NPI

Brittany Nicole Kozlak

  • Psychiatric/Mental Health Nurse Practitioner
  • Cleveland, OH
National Provider Identifier
1073386413
Registry record updated Aug 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0034551 Issued in OH
Practice address
3929 Rocky River Dr
Cleveland, OH 44111-4153
Phone
(216) 252-5800
NPI assigned
Nov 6, 2023
Last updated
Aug 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0034551 OH Primary

Addresses

Primary practice location

3929 Rocky River Dr
Cleveland, OH 44111-4153

Mailing address

3929 Rocky River Dr
Cleveland, OH 44111-4153
Phone (216) 252-5800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240605002765 OH Practitioner - Nurse Practitioner 7618419607 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0034551OHMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Circle Health Services CurrentSince Apr 16, 2024 Accepting new patients
Circle Health Services CurrentSince Apr 16, 2024 Accepting new patients
Circle Health Services Past Accepting new patients
Circle Health Services Past Accepting new patients
Circle Health Services Past Accepting new patients

Locations

12201 Euclid Ave
Cleveland, OH 44106
Phone (216) 373-2846

3929 Rocky River Dr
Cleveland, OH 44111
Phone (216) 252-5800

4400 Euclid Ave
Cleveland, OH 44103
Phone (216) 325-9355

4500 Euclid Ave
Cleveland, OH 44103
Phone (216) 325-9404

5209 Detroit Ave
Cleveland, OH 44102
Phone (216) 651-2037

5955 Ridge Rd
Parma, OH 44129
Phone (440) 888-0300

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1699228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1073386413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3929 ROCKY RIVER DR",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441114153",
            "telephone_number": "216-252-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3929 ROCKY RIVER DR",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441114153",
            "telephone_number": "216-252-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOZLAK",
        "first_name": "BRITTANY",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-06",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "0034551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.