Individual provider Active NPI

Annemarie Colosimo, LISW-S

  • Clinical Social Worker
  • Independence, OH
National Provider Identifier
1043980683
Registry record updated Sep 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0010016 Issued in OH
Practice address
6471 Brecksville Rd
Independence, OH 44131-3419
Phone
(216) 533-9132
NPI assigned
Sep 15, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2021

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 0010016 OH Primary

Addresses

Primary practice location

6471 Brecksville Rd
Independence, OH 44131-3419

Mailing address

6471 Brecksville Rd
Independence, OH 44131-3419
Phone (216) 533-9132

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
I20211208002759 OH Practitioner - Clinical Social Worker 8921498825 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sondermind Provider Network LLCGroup PAC ID 9537572490, 1,295 clinicians

Practice addresses (Care Compare)

20 S 3Rd St
Suite 210
Columbus, OH 43215-4206
Phone (866) 630-0966

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0010016OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sondermind Provider Network LLC Clinical CurrentSince Dec 2, 2021 Accepting new patients

Locations

20 S 3rd St
Ste 210
Columbus, OH 43215
Phone (614) 208-4973

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": "1631664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631664000000",
    "number": "1043980683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6471 BRECKSVILLE RD",
            "city": "INDEPENDENCE",
            "state": "OH",
            "postal_code": "441313419",
            "telephone_number": "216-533-9132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6471 BRECKSVILLE RD",
            "city": "INDEPENDENCE",
            "state": "OH",
            "postal_code": "441313419",
            "telephone_number": "216-533-9132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLOSIMO",
        "first_name": "ANNEMARIE",
        "credential": "LISW-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-15",
        "last_updated": "2021-09-15",
        "certification_date": "2021-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "0010016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, OH

Sources for this page

Verify at the official NPI Registry.