Individual provider Active NPI

Stephen L. Magruder, M.S.W.

  • Clinical Social Worker
  • Fort Myers, FL
National Provider Identifier
1073674735
Registry record updated Mar 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW 3006 Issued in FL
Practice address
12520 World Plaza LN
Suite 3
Fort Myers, FL 33907-3940
Phone
(239) 939-3700
Fax
(239) 939-3889
NPI assigned
Dec 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 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 SW 3006 FL Primary

Addresses

Primary practice location

12520 World Plaza LN
Suite 3
Fort Myers, FL 33907-3940

Mailing address

12520 World Plaza LN
Suite 3
Fort Myers, FL 33907-3940
Phone (239) 939-3700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20050722000600 FL Practitioner - Clinical Social Worker 3870520620 Practice locations: Bonita Springs, FL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

27499 Riverview Ctr Blvd
Suite 253
Bonita Springs, FL 34134-4359
Phone (239) 939-3700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW 3006FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Richard W. Haley, Inc. Past Accepting new patients
Stephen L Magruder Clinical PastSince Jan 1, 1990 Accepting new patients

Networks

  • Freedom Health HMO Network

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614816000000",
    "number": "1073674735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12520 WORLD PLAZA LN",
            "address_2": "SUITE 3",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073940",
            "telephone_number": "239-939-3700",
            "fax_number": "239-939-3889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12520 WORLD PLAZA LN",
            "address_2": "SUITE 3",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073940",
            "telephone_number": "239-939-3700",
            "fax_number": "239-939-3889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGRUDER",
        "first_name": "STEPHEN",
        "middle_name": "L.",
        "name_prefix": "Mr.",
        "credential": "M.S.W.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW 3006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.