Active NPI
Keragan L Fannin
- Social Worker
- Sandusky, OH
National Provider Identifier
1508629189
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- S.2403705-TRNE
- Practice address
- 1925 Hayes Ave
Sandusky, OH 44870-4737 - Phone
- (419) 557-5177
- NPI assigned
- Feb 5, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | S.2613825 | OH | |
| Case Manager/Care Coordinator | 171M00000X | |||
| Social Worker | 104100000X | S.2403705-TRNE | OH | Primary |
Addresses
Primary practice location
1925 Hayes Ave
Sandusky, OH 44870-4737
Mailing address
1925 Hayes Ave
Sandusky, OH 44870-4737
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S.2403705-TRNE | OH | MD | Social Worker |
| S.2613825 | OH | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1707091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1779408000000",
"number": "1508629189",
"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": "448704737",
"telephone_number": "419-557-5177"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1925 HAYES AVE",
"city": "SANDUSKY",
"state": "OH",
"postal_code": "448704737",
"telephone_number": "419-557-5177"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FANNIN",
"first_name": "KERAGAN",
"middle_name": "L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-02-05",
"last_updated": "2026-05-22",
"certification_date": "2026-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OH",
"license": "S.2613825",
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OH",
"license": "S.2403705-TRNE",
"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 May 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.