Individual provider Active NPI

Stanley M. Zupnick, PH. D.

  • Clinical Psychologist
  • Toledo, OH
National Provider Identifier
1679597348
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
195 Issued in OH
Practice address
5965 Renaissance PL
Toledo, OH 43623-4709
Phone
(419) 882-5678
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 195 OH Primary

Addresses

Primary practice location

5965 Renaissance PL
Toledo, OH 43623-4709

Mailing address

5965 Renaissance PL
Toledo, OH 43623-4709
Phone (419) 882-5678

Other identifiers 1

IdentifierTypeStateIssuer
0253158MedicaidOH

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
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
195OHMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1679597348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5965 RENAISSANCE PL",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234709",
            "telephone_number": "419-882-5678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5965 RENAISSANCE PL",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234709",
            "telephone_number": "419-882-5678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZUPNICK",
        "first_name": "STANLEY",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "PH. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "195",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0253158",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.