Individual provider Active NPI

John Bruce Kijowski, LISW-S

  • Clinical Social Worker
  • Sandusky, OH
National Provider Identifier
1336372663
Registry record updated Sep 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.0004736 Issued in OH
Practice address
1925 Hayes Ave
Sandusky, OH 44870-4793
Phone
(419) 557-5177
Fax
(419) 557-5179
NPI assigned
Sep 3, 2009
Last updated
Sep 3, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2009

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.0004736 OH Primary

Addresses

Primary practice location

1925 Hayes Ave
Sandusky, OH 44870-4793

Mailing address

1925 Hayes Ave.
Sandusky, OH 44870
Phone (419) 557-5177

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

NPI Registry JSON

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

{
    "created_epoch": "1251936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251936000000",
    "number": "1336372663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1925 HAYES AVE.",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "44870",
            "telephone_number": "419-557-5177",
            "fax_number": "419-557-5179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 HAYES AVE",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448704793",
            "telephone_number": "419-557-5177",
            "fax_number": "419-557-5179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIJOWSKI",
        "first_name": "JOHN",
        "middle_name": "BRUCE",
        "credential": "LISW-S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-03",
        "last_updated": "2009-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.0004736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandusky, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2009; 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.