Individual provider Active NPI

Matthew Wilson Karlovic, LPN

  • Licensed Practical Nurse
  • Youngstown, OH
National Provider Identifier
1790004232
Registry record updated May 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN120030MEDS Issued in OH
Practice address
1344 5TH Ave
Youngstown, OH 44504-1703
Phone
(330) 742-2595
Fax
(330) 742-2598
NPI assigned
May 24, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN120030MEDS OH Primary

Addresses

Primary practice location

1344 5TH Ave
Youngstown, OH 44504-1703

Mailing address

30 E Broad St
11TH Floor
Columbus, OH 43215-3430
Phone (604) 466-6583

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

LicenseStateTypeSpecialty
PN120030MEDSOHMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
State of Ohio Office of Budget and MGMT, State Accounting Past Accepting new patients
State of Ohio Office of Budget and Management State Accounting Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1274659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274659200000",
    "number": "1790004232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 E BROAD ST",
            "address_2": "11TH FLOOR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432153430",
            "telephone_number": "604-466-6583",
            "fax_number": "614-644-5331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1344 5TH AVE",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445041703",
            "telephone_number": "330-742-2595",
            "fax_number": "330-742-2598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARLOVIC",
        "first_name": "MATTHEW",
        "middle_name": "WILSON",
        "name_prefix": "Mr.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-24",
        "last_updated": "2010-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN120030MEDS",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2010; 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.