Active NPI
Timothy Lee Pawlaczyk, RN
- Registered Nurse
- Mansfield, OH
National Provider Identifier
1558981019
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- RN.349953
- Practice address
- 775 Lexington Ave
Mansfield, OH 44907-1906 - Phone
- (419) 774-4010
- NPI assigned
- Apr 24, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN.349953 | OH | Primary |
Addresses
Primary practice location
775 Lexington Ave
Mansfield, OH 44907-1906
Mailing address
2000 Noble Dr
Wooster, OH 44691-5353
Phone (330) 264-3232
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN.349953 | OH | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1587686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594771200000",
"number": "1558981019",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2000 NOBLE DR",
"city": "WOOSTER",
"state": "OH",
"postal_code": "446915353",
"telephone_number": "330-264-3232"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "775 LEXINGTON AVE",
"city": "MANSFIELD",
"state": "OH",
"postal_code": "449071906",
"telephone_number": "419-774-4010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAWLACZYK",
"first_name": "TIMOTHY",
"middle_name": "LEE",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-04-24",
"last_updated": "2020-07-15",
"certification_date": "2020-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "OH",
"license": "RN.349953",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mansfield, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.