Individual provider Active NPI

Aimee M Nielsen, LCSW

  • Clinical Social Worker
  • Fishers, IN
National Provider Identifier
1023290137
Registry record updated May 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34005917A Issued in IN
Practice address
10765 Lantern Road
Suite 102
Fishers, IN 46038-3597
Phone
(317) 621-4181
Fax
(317) 621-4182
NPI assigned
Nov 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2012

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 34005917A IN Primary

Addresses

Primary practice location

10765 Lantern Road
Suite 102
Fishers, IN 46038-3597

Mailing address

10765 Lantern Road
Suite 102
Fishers, IN 46038-3597
Phone (317) 621-4181

Other identifiers 5

IdentifierTypeStateIssuer
3423806OtherINCIGNA
682352OtherINVALUE OPTIONS
482619OtherINMANAGED HEALTH NETWORK
000000701149OtherINANTHEM
9084133OtherINAETNA

Other names 1

  • Aimee M Edmonds Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
34005917AINMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1196380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337644800000",
    "number": "1023290137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10765 LANTERN ROAD",
            "address_2": "SUITE 102",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460383597",
            "telephone_number": "317-621-4181",
            "fax_number": "317-621-4182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10765 LANTERN ROAD",
            "address_2": "SUITE 102",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460383597",
            "telephone_number": "317-621-4181",
            "fax_number": "317-621-4182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIELSEN",
        "first_name": "AIMEE",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-30",
        "last_updated": "2012-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34005917A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "3423806",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "682352",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MANAGED HEALTH NETWORK",
            "identifier": "482619",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000701149",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9084133",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AIMEE",
            "last_name": "EDMONDS",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fishers, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2012; 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.