Individual provider Active NPI

Ethel A Elkins, LCSW

  • Clinical Social Worker
  • Fort Branch, IN
National Provider Identifier
1013951052
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34002277A Issued in IN
Practice address
123 N McCreary St
Fort Branch, IN 47648-1313
Phone
(812) 753-1039
Fax
(812) 753-1122
NPI assigned
Jun 16, 2006
Last updated
Feb 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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 34002277A IN Primary

Addresses

Primary practice location

123 N McCreary St
Fort Branch, IN 47648-1313

Mailing address

108 N Main St
Princeton, IN 47670-1540
Phone (812) 753-1039

Other practice location 1

108 N Main St
Princeton, IN 47670-1540
Phone (812) 753-1039

Other identifiers 2

IdentifierTypeStateIssuer
371620615OtherINTRICARE PIN
000000381376OtherINANTHEM PIN

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
I20040601001542 IN Practitioner - Clinical Social Worker 4688656978 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34002277AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Cross Pointe Past Accepting new patients
Deaconess Cross Pointe Center, LLC Clinical Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ethel.elkins@tfhc.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/FGEDBA/Endpoint/FGEDBA

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1013951052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 N MAIN ST",
            "city": "PRINCETON",
            "state": "IN",
            "postal_code": "476701540",
            "telephone_number": "812-753-1039",
            "fax_number": "812-753-1122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 N MCCREARY ST",
            "city": "FORT BRANCH",
            "state": "IN",
            "postal_code": "476481313",
            "telephone_number": "812-753-1039",
            "fax_number": "812-753-1122"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "108 N Main St",
            "address_purpose": "LOCATION",
            "city": "Princeton",
            "state": "IN",
            "postal_code": "476701540",
            "country_code": "US",
            "telephone_number": "812-753-1039",
            "fax_number": "812-753-1122",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELKINS",
        "first_name": "ETHEL",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-16",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34002277A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE PIN",
            "identifier": "371620615",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PIN",
            "identifier": "000000381376",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Branch, IN

Sources for this page

Verify at the official NPI Registry.