Active NPI
Dawn Marie Mbomyo, MSW, LISW-S
- Social Worker
- Columbus, OH
National Provider Identifier
1083974737
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- I.1000001-SUPV
- Practice address
- 420 N James Rd
Columbus, OH 43219-1834 - Phone
- (614) 593-2325
- NPI assigned
- May 29, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | I.1000001-SUPV | OH | Primary |
Addresses
Primary practice location
420 N James Rd
Columbus, OH 43219-1834
Mailing address
420 N James Rd
Columbus, OH 43219-1834
Phone (614) 593-2325
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| I.1000001-SUPV | OH | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1338249600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707091200000",
"number": "1083974737",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "420 N JAMES RD",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432191834",
"telephone_number": "614-593-2325"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "420 N JAMES RD",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432191834",
"telephone_number": "614-593-2325"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MBOMYO",
"first_name": "DAWN",
"middle_name": "MARIE",
"credential": "MSW, LISW-S",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-05-29",
"last_updated": "2024-02-05",
"certification_date": "2024-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OH",
"license": "I.1000001-SUPV",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.