Individual provider Active NPI

Aaron Goldsberry

  • Clinical Social Worker
  • Kokomo, IN
National Provider Identifier
1073269767
Registry record updated Feb 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34009610A Issued in IN
Practice address
322 N Main St
Kokomo, IN 46901-4622
Phone
(765) 453-8555
NPI assigned
Feb 22, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2022

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 34009610A IN Primary

Addresses

Primary practice location

322 N Main St
Kokomo, IN 46901-4622

Mailing address

6626 E 75TH St Ste 500
Indianapolis, IN 46250-2890
Phone (317) 621-7584

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: No
  • 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
I20220526002337 IN Practitioner - Clinical Social Worker 0648658922 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Midwest Behavioral Health LLCGroup PAC ID 4587834874, 132 clinicians

Practice addresses (Care Compare)

10801 N Michigan Rd
Suite 240
Zionsville, IN 46077-7845
Phone (317) 558-0630

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34009610AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Behavioral Health LLC CurrentSince Jul 1, 2022 Accepting new patients

Locations

7300 E Indiana St
Ste 103
Evansville, IN 47715
Phone (812) 401-8008

10801 N Michigan Rd
Ste 240
Zionsville, IN 46077
Phone (317) 558-0630

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, 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": "1645488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645488000000",
    "number": "1073269767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST STE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890",
            "telephone_number": "317-621-7584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 N MAIN ST",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469014622",
            "telephone_number": "765-453-8555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSBERRY",
        "first_name": "AARON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-22",
        "last_updated": "2022-02-22",
        "certification_date": "2022-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34009610A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kokomo, IN

Sources for this page

Verify at the official NPI Registry.