Individual provider Active NPI

Jonathan Hugh Pansky, PHD

  • Clinical Psychologist
  • Toledo, OH
National Provider Identifier
1346365665
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
4488 Issued in OH
Practice address
4334 Secor Rd
Toledo, OH 43623-4234
Phone
(419) 475-4449
Fax
(419) 479-3230
NPI assigned
Mar 20, 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
Clinical Psychologist 103TC0700X 4488 OH Primary

Addresses

Primary practice location

4334 Secor Rd
Toledo, OH 43623-4234

Mailing address

4334 Secor Rd
Toledo, OH 43623-4234
Phone (419) 475-4449

Other identifiers 1

IdentifierTypeStateIssuer
02104OtherPARAMOUNT HEALTH CARE

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
4488OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Court Diagnostic & Treatment Center Past Accepting new patients
Harbor Clinical Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346365665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4334 SECOR RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234234",
            "telephone_number": "419-475-4449",
            "fax_number": "419-479-3230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4334 SECOR RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234234",
            "telephone_number": "419-475-4449",
            "fax_number": "419-479-3230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANSKY",
        "first_name": "JONATHAN",
        "middle_name": "HUGH",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "4488",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARAMOUNT HEALTH CARE",
            "identifier": "02104",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, 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.