Individual provider Active NPI

Joseph Jablonski

  • Psychiatric/Mental Health Nurse Practitioner
  • Wauseon, OH
National Provider Identifier
1902681463
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0036787 Issued in OH
Practice address
725 S Shoop Ave
Wauseon, OH 43567-1701
Phone
(419) 337-8661
NPI assigned
Aug 31, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN.452054 OH
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN.CNP.0036787 OH
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0036787 OH Primary

Addresses

Primary practice location

725 S Shoop Ave
Wauseon, OH 43567-1701

Mailing address

29071 Belmont Lake Rd
Perrysburg, OH 43551-3702
Phone (734) 347-1423

Other practice location 1

29071 Belmont Lake Rd
Perrysburg, OH 43551-3702
Phone (734) 347-1423

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240924000708 OH Practitioner - Nurse Practitioner 2466993084 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Toledo College of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
FCHC Medical Care, LLCGroup PAC ID 8022018704, 58 clinicians

Practice addresses (Care Compare)

725 S Shoop Ave
Wauseon, OH 43567-1701
Phone (419) 335-2015

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN.452054OHMDRegistered Nurse
0036787OHMDPsychiatric/Mental Health Nurse Practitioner
APRN.CNP.0036787OHMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
FCHC Medical Care, LLC CurrentSince Jul 15, 2024 Accepting new patients
Fulton County Health Center Past Accepting new patients

Locations

L3493
Columbus, OH 43260

L4133
Columbus, OH 43260

725 S Shoop Ave
Wauseon, OH 43567
Phone (419) 335-2015

495 S Shoop Ave
Wauseon, OH 43567
Phone (419) 330-2790

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1693440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1902681463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29071 BELMONT LAKE RD",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435513702",
            "telephone_number": "734-347-1423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 S SHOOP AVE",
            "city": "WAUSEON",
            "state": "OH",
            "postal_code": "435671701",
            "telephone_number": "419-337-8661"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "29071 Belmont Lake Rd",
            "address_purpose": "LOCATION",
            "city": "Perrysburg",
            "state": "OH",
            "postal_code": "435513702",
            "country_code": "US",
            "telephone_number": "734-347-1423",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JABLONSKI",
        "first_name": "JOSEPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-08-31",
        "last_updated": "2024-07-03",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.452054",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.0036787",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "0036787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauseon, OH

Sources for this page

Verify at the official NPI Registry.