Individual provider Active NPI

Jody L. Hirst, LCSW

  • Clinical Social Worker
  • Indianapolis, IN
National Provider Identifier
1063682755
Registry record updated Feb 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34001573A Issued in IN
Practice address
6040 W 84TH St
Indianapolis, IN 46278-1360
Phone
(317) 956-6288
Fax
(317) 956-6289
NPI assigned
Mar 10, 2008
Last updated
Feb 19, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 19, 2013

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 34001573A IN Primary

Addresses

Primary practice location

6040 W 84TH St
Indianapolis, IN 46278-1360

Mailing address

394 Ventana CT
Indianapolis, IN 46290-1095
Phone (317) 564-4462

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
I20080722000003 IN Practitioner - Clinical Social Worker 4385717560 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pike Medical Consultants PCGroup PAC ID 1850495003, 25 clinicians

Practice addresses (Care Compare)

762 N Dan Jones Rd
Gericare Indy
Avon, IN 46123-6213
Phone (317) 956-6288

7911 Michigan Rd
Indianapolis, IN 46268-1915

7911 N Michigan Rd
Indianapolis, IN 46268-1915
Phone (317) 956-6288

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pike Medical Consultants PC CurrentSince Nov 3, 2012 Accepting new patients
Urgent Care Services Inc Past Accepting new patients

Locations

762 N Dan Jones Rd
Avon, IN 46123
Phone (201) 856-0224

6040 W 84th St
Indianapolis, IN 46278
Phone (317) 956-1080

7911 Michigan Rd
Indianapolis, IN 46268
Phone (317) 960-3278

7911 Michigan Rd
Ste B
Indianapolis, IN 46268
Phone (317) 956-6289

Organizations & group practices 2

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": "1205107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361232000000",
    "number": "1063682755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "394 VENTANA CT",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462901095",
            "telephone_number": "317-564-4462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6040 W 84TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462781360",
            "telephone_number": "317-956-6288",
            "fax_number": "317-956-6289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIRST",
        "first_name": "JODY",
        "middle_name": "L.",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-10",
        "last_updated": "2013-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34001573A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.