Individual provider Active NPI

Kenneth Kowalski

  • Psychiatric/Mental Health Nurse Practitioner
  • Sylvania, OH
National Provider Identifier
1396375770
Registry record updated Apr 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN.CNP.2020038374 Issued in OH
Practice address
5300 Harroun Rd Ste 212
Sylvania, OH 43560-2146
Phone
(419) 776-8000
NPI assigned
Jan 24, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN.CNP.2020038374 OH Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

5300 Harroun Rd Ste 212
Sylvania, OH 43560-2146

Mailing address

5300 Harroun Rd Ste 212
Sylvania, OH 43560-2146
Phone (419) 776-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210401000611 OH Practitioner - Nurse Practitioner 9133536550 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN.CNP.2020038374OHMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Recovery Services of Northwest Ohio, Inc CurrentSince Feb 4, 2022 Accepting new patients
RX Solutions Nwo, Inc. CurrentSince Aug 28, 2022 Accepting new patients
TMS Solutions Inc CurrentSince Jun 1, 2025 Accepting new patients
360Team Psychiatry LLC Psychiatric/Mental Health CurrentSince Oct 18, 2022 Accepting new patients

Locations

12910 Shelbyville Rd
Ste 300
Louisville, KY 40243
Phone (502) 214-0693

200 Van Gundy Dr
Bryan, OH 43506
Phone (419) 636-0410

511 Perry St
Defiance, OH 43512
Phone (419) 782-4933

118 E Clinton St
Napoleon, OH 43545
Phone (419) 599-7040

740 Commerce Dr
Ste A
Perrysburg, OH 43551
Phone 24852821166

5300 Harroun Rd
Ste 212
Sylvania, OH 43560
Phone (419) 291-3100

4895 Monroe St
Ste 200
Toledo, OH 43623
Phone (419) 558-0800

560 W Linfoot St
Wauseon, OH 43567
Phone (419) 337-1973

765 E Holland Ave
Ste 1
Spokane, WA 99218
Phone (509) 242-6005

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/rsnwo/r4/

Organizations & group practices 4

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": "1579824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776211200000",
    "number": "1396375770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 HARROUN RD STE 212",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435602146",
            "telephone_number": "419-776-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 HARROUN RD STE 212",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435602146",
            "telephone_number": "419-776-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOWALSKI",
        "first_name": "KENNETH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-24",
        "last_updated": "2026-04-15",
        "certification_date": "2026-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.2020038374",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sylvania, OH

Sources for this page

Verify at the official NPI Registry.