Active NPI
Brandon J Kozinski, DO
- Pediatrics Physician
- Columbia, MO
National Provider Identifier
1124680871
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 2019022921
- Practice address
- 404 N Keene St
Columbia, MO 65201-6626 - Phone
- (573) 882-4438
- Fax
- (573) 884-9992
- NPI assigned
- Jul 2, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 2019022921 | MO | Primary |
Addresses
Primary practice location
404 N Keene St
Columbia, MO 65201-6626
Mailing address
400 N Keene St
Columbia, MO 65201-6626
Phone (573) 882-4438
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)
- Not enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2019022921 | MO | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sheboygan Pediatric Associates SC | Pediatrics | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pediatrics Physician
- Sheboygan, WI
- NPI 1134285182
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1562025600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562025600000",
"number": "1124680871",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 N KEENE ST",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "652016626",
"telephone_number": "573-882-4438",
"fax_number": "573-884-9992"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "404 N KEENE ST",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "652016626",
"telephone_number": "573-882-4438",
"fax_number": "573-884-9992"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOZINSKI",
"first_name": "BRANDON",
"middle_name": "J",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-07-02",
"last_updated": "2019-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MO",
"license": "2019022921",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbia, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.