Individual provider Active NPI

Jordan Leigh Rhodes, LISW, MSW

  • Clinical Social Worker
  • Boardman, OH
National Provider Identifier
1023567740
Registry record updated Nov 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.1801107 Issued in OH
Practice address
4822 Market St
Boardman, OH 44512-2148
Phone
(330) 544-8005
Fax
(330) 544-9379
NPI assigned
Sep 22, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2018

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 S.1600786 OH
Clinical Social Worker 1041C0700X I.1801107 OH Primary

Addresses

Primary practice location

4822 Market St
Boardman, OH 44512-2148

Mailing address

4822 Market St
Boardman, OH 44512-2148
Phone (330) 544-8005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20190218001181 OH Practitioner - Clinical Social Worker 6901144989 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rajendra P Koirala, M.D., LLCGroup PAC ID 8820334931, 23 clinicians

Practice addresses (Care Compare)

725 Boardman Canfield Rd
Suite L1
Boardman, OH 44512-4370
Phone (330) 330-8655

Merit-based Incentive Payment System (MIPS)

Final score
41.34 of 100Reported as group
Quality
20.12
Improvement activities
0
Cost
84.26

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S.1600786OHMDSocial Worker
I.1801107OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Rajendra P Koirala, M.D., LLC CurrentSince Nov 4, 2024 Accepting new patients
Psycare, Inc. CurrentSince Feb 5, 2019 Accepting new patients
Psy-Care Inc Clinical CurrentSince Feb 5, 2019 Accepting new patients
Cadence Care Network Past Accepting new patients

Locations

725 Boardman Canfield Rd
Ste L1
Youngstown, OH 44512
Phone (330) 330-8655

2980 Belmont Ave
Youngstown, OH 44505
Phone (330) 759-0276

Organizations & group practices 4

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": "1474502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543276800000",
    "number": "1023567740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4822 MARKET ST",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445122148",
            "telephone_number": "330-544-8005",
            "fax_number": "330-544-9379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4822 MARKET ST",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445122148",
            "telephone_number": "330-544-8005",
            "fax_number": "330-544-9379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RHODES",
        "first_name": "JORDAN",
        "middle_name": "LEIGH",
        "credential": "LISW, MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-22",
        "last_updated": "2018-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.1600786",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1801107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boardman, OH

Sources for this page

Verify at the official NPI Registry.