Individual provider Active NPI

Branden Fox, MSW LISW

  • Social Worker
  • Oregon, OH
National Provider Identifier
1962949255
Registry record updated Jan 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
I.2406081 Issued in OH
Practice address
2737 Navarre Ave Ste 205
Oregon, OH 43616-3276
Phone
(419) 691-8500
NPI assigned
Jan 24, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X S.2107095 OH
Social Worker 104100000X I.2406081 OH Primary

Addresses

Primary practice location

2737 Navarre Ave Ste 205
Oregon, OH 43616-3276

Mailing address

2397 N Toussaint Portage Rd
Oak Harbor, OH 43449-9567
Phone (419) 340-1669

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250106003374 OH Practitioner - Clinical Social Worker 9537697461 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.2406081OHMDSocial Worker
S.2107095OHMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mylo Jennings & Associates, LLC CurrentSince Jan 1, 2025 Accepting new patients
Michelle Coutcher and Associates LLC PastSince Jan 5, 2025 Accepting new patients

Locations

2737 Navarre Ave
Ste 205
Oregon, OH 43616
Phone (419) 691-8500

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": "1485216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737676800000",
    "number": "1962949255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2397 N TOUSSAINT PORTAGE RD",
            "city": "OAK HARBOR",
            "state": "OH",
            "postal_code": "434499567",
            "telephone_number": "419-340-1669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2737 NAVARRE AVE STE 205",
            "city": "OREGON",
            "state": "OH",
            "postal_code": "436163276",
            "telephone_number": "419-691-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOX",
        "first_name": "BRANDEN",
        "credential": "MSW LISW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-01-24",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.2107095",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "I.2406081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oregon, OH

Sources for this page

Verify at the official NPI Registry.