Active NPI
Tim Roy Fancote Jr., LSW
- Social Worker
- Middletown, OH
National Provider Identifier
1831980267
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- S.2411693
- Practice address
- 134 N Breiel Blvd
Middletown, OH 45042-3806 - Phone
- (513) 228-6590
- NPI assigned
- May 15, 2025
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | S.2411693 | OH | Primary |
Addresses
Primary practice location
134 N Breiel Blvd
Middletown, OH 45042-3806
Mailing address
134 N Breiel Blvd
Middletown, OH 45042-3806
Phone (513) 228-6590
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
| License | State | Type | Specialty |
|---|---|---|---|
| S.2411693 | OH | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1747267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747267200000",
"number": "1831980267",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "134 N BREIEL BLVD",
"city": "MIDDLETOWN",
"state": "OH",
"postal_code": "450423806",
"telephone_number": "513-228-6590"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "134 N BREIEL BLVD",
"city": "MIDDLETOWN",
"state": "OH",
"postal_code": "450423806",
"telephone_number": "513-228-6590"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FANCOTE",
"first_name": "TIM",
"middle_name": "ROY",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "LSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-05-15",
"last_updated": "2025-05-15",
"certification_date": "2025-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OH",
"license": "S.2411693",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Middletown, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.