Healthcare Provider Details

I. General information

NPI: 1104754068
Provider Name (Legal Business Name): URBAN WHIZ KIDZ ACADEMY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1417 BRENTNELL AVE
COLUMBUS OH
43219-2058
US

IV. Provider business mailing address

1676 FRANKLIN AVE
COLUMBUS OH
43205-2169
US

V. Phone/Fax

Practice location:
  • Phone: 614-965-0150
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State

VIII. Authorized Official

Name: JIMMICA P WILSON
Title or Position: HR ADMINISTRATOR
Credential:
Phone: 614-404-2340