Individual provider Active NPI

Jay Twardowski

  • Home Modifications Contractor
  • Lebanon, OH
National Provider Identifier
1194124008
Registry record updated Aug 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Modifications ContractorTaxonomy code 171WH0202X
Practice address
1358 Orchard Run Dr
Lebanon, OH 45036-9251
Phone
(513) 520-7267
NPI assigned
Aug 15, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Modifications Contractor 171WH0202X Primary

Addresses

Primary practice location

1358 Orchard Run Dr
Lebanon, OH 45036-9251

Mailing address

1358 Orchard Run Dr
Lebanon, OH 45036-9251

Other identifiers 1

IdentifierTypeStateIssuer
0960474MedicaidOH

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

NPI Registry JSON

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

{
    "created_epoch": "1408060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408060800000",
    "number": "1194124008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1358 ORCHARD RUN DR",
            "city": "LEBANON",
            "state": "OH",
            "postal_code": "450369251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1358 ORCHARD RUN DR",
            "city": "LEBANON",
            "state": "OH",
            "postal_code": "450369251",
            "telephone_number": "513-520-7267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TWARDOWSKI",
        "first_name": "JAY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-08-15",
        "last_updated": "2014-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171WH0202X",
            "taxonomy_group": "",
            "desc": "Contractor, Home Modifications",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0960474",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.