Individual provider Active NPI

Christopher M Sidote, LISW-S

  • Clinical Social Worker
  • Zanesville, OH
National Provider Identifier
1104210350
Registry record updated Mar 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.1201042.SUPV Issued in OH
Practice address
2845 Bell St
Zanesville, OH 43701-1720
Phone
(740) 454-9766
Fax
(740) 588-6452
NPI assigned
Mar 26, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2015

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 I.1201042.SUPV OH Primary

Addresses

Primary practice location

2845 Bell St
Zanesville, OH 43701-1720

Mailing address

915 S Riverside Dr NE
McConnelsville, OH 43756-9102
Phone (740) 962-5204

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
I.1201042.SUPVOHMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1427328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427328000000",
    "number": "1104210350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 S RIVERSIDE DR NE",
            "city": "MCCONNELSVILLE",
            "state": "OH",
            "postal_code": "437569102",
            "telephone_number": "740-962-5204",
            "fax_number": "740-588-6452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2845 BELL ST",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "437011720",
            "telephone_number": "740-454-9766",
            "fax_number": "740-588-6452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDOTE",
        "first_name": "CHRISTOPHER",
        "middle_name": "M",
        "credential": "LISW-S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-26",
        "last_updated": "2015-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1201042.SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Zanesville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2015; 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.