Individual provider Active NPI

Elizabeth Brandon, MSW

  • Social Worker
  • Paxton, IL
National Provider Identifier
1073845954
Registry record updated Sep 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
1510 W Ottawa Rd
Paxton, IL 60957-4090
Phone
(217) 379-4302
NPI assigned
Feb 3, 2010
Last updated
Sep 10, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2019

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 NU Primary

Addresses

Primary practice location

1510 W Ottawa Rd
Paxton, IL 60957-4090

Mailing address

1801 Fox Dr
Champaign, IL 61820-7236

Other names 1

  • Elizabeth Guidry Former name

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1265155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568073600000",
    "number": "1073845954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 FOX DR",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618207236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 W OTTAWA RD",
            "city": "PAXTON",
            "state": "IL",
            "postal_code": "609574090",
            "telephone_number": "217-379-4302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDON",
        "first_name": "ELIZABETH",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-03",
        "last_updated": "2019-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "GUIDRY",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Paxton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2019; 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.