Active NPI
John E Klosowski, DO
- Family Medicine Physician
- Bad Axe, MI
National Provider Identifier
1679868053
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 5101019125
- Practice address
- 1080 S Van Dyke
Suite B
Bad Axe, MI 48413 - Phone
- (989) 269-8999
- Fax
- (989) 269-6174
- NPI assigned
- Jun 14, 2011
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 5101019125 | MI | Primary |
Addresses
Primary practice location
1080 S Van Dyke
Suite B
Bad Axe, MI 48413
Mailing address
1100 S Van Dyke
Bad Axe, MI 48413
Phone (989) 269-9521
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)
- Enrolled
- Credentials
- Doctor of Osteopathy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308009600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1456704000000",
"number": "1679868053",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 S VAN DYKE",
"city": "BAD AXE",
"state": "MI",
"postal_code": "48413",
"telephone_number": "989-269-9521",
"fax_number": "989-269-1562"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1080 S VAN DYKE",
"address_2": "SUITE B",
"city": "BAD AXE",
"state": "MI",
"postal_code": "48413",
"telephone_number": "989-269-8999",
"fax_number": "989-269-6174"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLOSOWSKI",
"first_name": "JOHN",
"middle_name": "E",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-06-14",
"last_updated": "2016-02-29",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MI",
"license": "5101019125",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bad Axe, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.