Active NPI
Casey Iverson
- Social Worker
- Ashtabula, OH
National Provider Identifier
1093298697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- S.1903863
- Practice address
- 525 Lake Ave
Ashtabula, OH 44004-3261 - Phone
- (440) 536-5680
- NPI assigned
- Sep 10, 2018
- 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 | S.1903863 | OH | Primary |
Addresses
Primary practice location
525 Lake Ave
Ashtabula, OH 44004-3261
Mailing address
695 South St Ste 6
Chardon, OH 44024-1474
Other practice location 1
695 South St Ste 6
Chardon, OH 44024-1474
Phone (440) 286-1553
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
| License | State | Type | Specialty |
|---|---|---|---|
| S.1903863 | OH | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Pride of Northeast Ohio Incorporated | Past | Accepting new patients | |
| Family Pride of Northeast Ohio Incorporated | Past | Accepting new patients |
Interoperability endpoints
- https://api.qualifacts.org/api/fhir/familyprideonline/r4/
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.
-
- Community/Behavioral Health Agency
- Chardon, OH
- NPI 1427013556
-
- Community/Behavioral Health Agency
- Chardon, OH
- NPI 1881049807
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536537600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626134400000",
"number": "1093298697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "695 SOUTH ST STE 6",
"city": "CHARDON",
"state": "OH",
"postal_code": "440241474"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "525 LAKE AVE",
"city": "ASHTABULA",
"state": "OH",
"postal_code": "440043261",
"telephone_number": "440-536-5680"
}
],
"practiceLocations": [
{
"address_1": "695 South St Ste 6",
"address_purpose": "LOCATION",
"city": "Chardon",
"state": "OH",
"postal_code": "440241474",
"country_code": "US",
"telephone_number": "440-286-1553",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "IVERSON",
"first_name": "CASEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-10",
"last_updated": "2021-07-13",
"certification_date": "2021-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OH",
"license": "S.1903863",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ashtabula, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.