Individual provider Active NPI

Ramona L. Wilzbacher, MSW, LCSW

  • Clinical Social Worker
  • Evansville, IN
National Provider Identifier
1013230093
Registry record updated Jun 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34005668A Issued in IN
Practice address
60 S. Stockwell Road
Evansville, IN 47714-0247
Phone
(812) 476-5437
Fax
(812) 422-7558
NPI assigned
Mar 5, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 34005668A IN Primary

Addresses

Primary practice location

60 S. Stockwell Road
Evansville, IN 47714-0247

Mailing address

415 Mulberry Street
Evansville, IN 47713-1230
Phone (812) 423-7791

Other identifiers 3

IdentifierTypeStateIssuer
000000673945OtherINANTHEM
12138317OtherINCAQH
100240880MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20100813000388 IN Practitioner - Clinical Social Worker 7315071289 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Networks

  • devoted network organization-1baeae7e-6b6f-49f9-a562-1b2d2e55c806
  • IL PPO Downstate
  • IL HMO C-SNP
  • OH PPO
  • KY PPO C-SNP
  • KY PPO

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": "1267747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403481600000",
    "number": "1013230093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 MULBERRY STREET",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477131230",
            "telephone_number": "812-423-7791",
            "fax_number": "812-422-7558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 S. STOCKWELL ROAD",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477140247",
            "telephone_number": "812-476-5437",
            "fax_number": "812-422-7558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILZBACHER",
        "first_name": "RAMONA",
        "middle_name": "L.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-05",
        "last_updated": "2014-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34005668A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000673945",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12138317",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100240880",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.