Individual provider Active NPI

Marilyn M. Caruthers

  • Social Worker
  • Gary, IN
National Provider Identifier
1073834875
Registry record updated Jun 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
33001019A Issued in IN
Practice address
308 E 21St Ave
Gary, IN 46407-2618
Phone
(219) 886-1320
Fax
(219) 886-1319
NPI assigned
Jun 15, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 33001019A IN Primary

Addresses

Primary practice location

308 E 21St Ave
Gary, IN 46407-2618

Mailing address

308 E 21St Ave
Gary, IN 46407-2618
Phone (219) 886-1320

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
33001019AINMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1276560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276560000000",
    "number": "1073834875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 E 21ST AVE",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464072618",
            "telephone_number": "219-886-1320",
            "fax_number": "219-886-1319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 E 21ST AVE",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464072618",
            "telephone_number": "219-886-1320",
            "fax_number": "219-886-1319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARUTHERS",
        "first_name": "MARILYN",
        "middle_name": "M.",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-15",
        "last_updated": "2010-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IN",
            "license": "33001019A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gary, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.