Individual provider Active NPI

John David Vennetti, MSED,LSW

  • Social Worker
  • Warren, OH
National Provider Identifier
1164576799
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
S0020647 Issued in OH
Practice address
150 E Market St
Warren, OH 44481-1141
Phone
(330) 399-6451
Fax
(330) 394-6848
NPI assigned
Jan 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X S0020647 OH Primary

Addresses

Primary practice location

150 E Market St
Warren, OH 44481-1141

Mailing address

908 Larkridge Ave
Boardman, OH 44512-3135

Other identifiers 1

IdentifierTypeStateIssuer
000000125424OtherOHANTHEM

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

State licenses

LicenseStateTypeSpecialty
S0020647OHMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164576799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 LARKRIDGE AVE",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445123135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 E MARKET ST",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444811141",
            "telephone_number": "330-399-6451",
            "fax_number": "330-394-6848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENNETTI",
        "first_name": "JOHN",
        "middle_name": "DAVID",
        "credential": "MSED,LSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S0020647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000125424",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.