Individual provider Active NPI

John Stanley Talley, LCSW

  • Clinical Social Worker
  • Bogalusa, LA
National Provider Identifier
1003075623
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4008 Issued in LA
Practice address
420 Avenue F
Bogalusa, LA 70427-3600
Phone
(985) 732-0058
Fax
(985) 732-0019
NPI assigned
Jun 9, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 4008 LA
Clinical Social Worker 1041C0700X 4008 LA Primary

Addresses

Primary practice location

420 Avenue F
Bogalusa, LA 70427-3600

Mailing address

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816-6038
Phone (225) 526-0001

Other identifiers 1

IdentifierTypeStateIssuer
4008OtherLASOCIAL WORK EXAMINERS LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20080819000409 LA Practitioner - Clinical Social Worker 1052486594 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

420 Ave F
Bogalusa, LA 70427-3634
Phone (985) 730-6706

433 Plaza St
Bogalusa, LA 70427-3729
Phone (985) 730-6706

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4008LAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Our Lady of the Angels Hospital, Inc. CurrentSince Mar 17, 2014 Accepting new patients

Locations

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816
Phone (225) 526-0011

433 Plaza St
Bogalusa, LA 70427
Phone (985) 730-6700

420 Avenue F
Bogalusa, LA 70427
Phone (985) 730-6970

Networks

  • TX HMO
  • MS PPO D-SNP
  • MS PPO C-SNP
  • MS PPO
  • TX HMO D-SNP

Organizations & group practices 1

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": "1212969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1003075623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 S SHERWOOD FOREST BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708166038",
            "telephone_number": "225-526-0001",
            "fax_number": "225-765-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 AVENUE F",
            "city": "BOGALUSA",
            "state": "LA",
            "postal_code": "704273600",
            "telephone_number": "985-732-0058",
            "fax_number": "985-732-0019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALLEY",
        "first_name": "JOHN",
        "middle_name": "STANLEY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-09",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "LA",
            "license": "4008",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "4008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOCIAL WORK EXAMINERS LICENSE",
            "identifier": "4008",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bogalusa, LA

Sources for this page

Verify at the official NPI Registry.