Lawrence E Mieczkowski, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

OH35-05-2076 Issued in OH

Practice address

3080 Ackerman Blvd Ste 220
Kettering, OH 45429-3658

Phone

(937) 294-3228

Fax

(937) 294-3250

NPI assigned

Aug 31, 2005

Last updated

Apr 16, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Center for Cardiometabolic Treatment & Education, Inc.

  • Specialist
  • Kettering, OH
  • NPI 1508959255
  Authorized official Same address or phone
• Lima Memorial Joint Operating Company

  dba Lima Memorial Health System

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

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

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523836800000",
    "number": "1558354951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3080 ACKERMAN BLVD STE 220",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454293658",
            "telephone_number": "937-294-3228",
            "fax_number": "937-394-3250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3080 ACKERMAN BLVD STE 220",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454293658",
            "telephone_number": "937-294-3228",
            "fax_number": "937-294-3250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIECZKOWSKI",
        "first_name": "LAWRENCE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-31",
        "last_updated": "2018-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OH",
            "license": "OH35-05-2076",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITEDHEALTHCARE",
            "identifier": "04-20157",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0603574",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA LIFE INSURANCE CO",
            "identifier": "0634819",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000020506",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "E00311469434",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary K Middlestetter, CRNA
• Midwest Behavioral Care
• Midwest Hyperbaric Physicians Inc
• Midwest Therapy Associates, Inc.
• Midwest Therapy Associates, Inc.
• Nancy R. Milam, PSY.D.
• Karen Faylynn Miliner
• Christopher Paul Miller, M.D.
• Deborah Miller, RDCS, RVT, RDMS
• John Mark Miller, D.O

• Specialist in Kettering, OH
• Providers in Kettering, OH by specialty
• Specialist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2018; 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.