Individual provider Active NPI

Gary Klozenbucher, LSCSW

  • Social Worker
  • Fort Riley, KS
National Provider Identifier
1972799690
Registry record updated Jul 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
1571 Issued in KS
Practice address
Building 7672
Fort Riley, KS 66442-4030
Phone
(788) 240-6189
NPI assigned
Sep 17, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 1571 KS Primary

Addresses

Primary practice location

Building 7672
Fort Riley, KS 66442-4030

Mailing address

650 Huebner Rd
Fort Riley, KS 66442-4030
Phone (788) 239-7208

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
1571KSMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1189987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689638400000",
    "number": "1972799690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 HUEBNER RD",
            "city": "FORT RILEY",
            "state": "KS",
            "postal_code": "664424030",
            "telephone_number": "788-239-7208",
            "fax_number": "785-239-7364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BUILDING 7672",
            "city": "FORT RILEY",
            "state": "KS",
            "postal_code": "664424030",
            "telephone_number": "788-240-6189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLOZENBUCHER",
        "first_name": "GARY",
        "credential": "LSCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-17",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "KS",
            "license": "1571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Riley, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2023; 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.