Individual provider Active NPI

Jonathan D Vonspiegel

  • Substance Abuse Rehabilitation Facility
  • Warren, OH
National Provider Identifier
1447864145
Registry record updated Apr 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
174347 Issued in OH
Practice address
4930 Enterprise Dr NW
Warren, OH 44481-8706
Phone
(330) 787-0955
NPI assigned
Sep 1, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X CDCA.174347 OH
Substance Abuse Rehabilitation Facility 324500000X 174347 OH Primary

Addresses

Primary practice location

4930 Enterprise Dr NW
Warren, OH 44481-8706

Mailing address

4930 Enterprise Dr NW
Warren, OH 44481-8706
Phone (330) 787-0955

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
CDCA.174347OHMDCounselor
174347OHMDSubstance Abuse Rehabilitation Facility

Practice roles

OrganizationSpecialtyStatusNew patients
FSR of Parkman LLC CurrentSince Sep 18, 2024 Accepting new patients

Locations

4930 Enterprise Dr NW
Warren, OH 44481
Phone 3303698022 ext. 153

Interoperability endpoints

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

Organizations & group practices 1

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": "1598918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618185600000",
    "number": "1447864145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4930 ENTERPRISE DR NW",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444818706",
            "telephone_number": "330-787-0955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4930 ENTERPRISE DR NW",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444818706",
            "telephone_number": "330-787-0955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VONSPIEGEL",
        "first_name": "JONATHAN",
        "middle_name": "D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-01",
        "last_updated": "2021-04-12",
        "certification_date": "2021-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OH",
            "license": "CDCA.174347",
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "OH",
            "license": "174347",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Apr 12, 2021; 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.