Individual provider Active NPI

Melissa Jane Williams, LCSW

  • Clinical Social Worker
  • Idaho Falls, ID
National Provider Identifier
1093930596
Registry record updated Jun 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34353 Issued in ID
Practice address
1810 Moran St
Idaho Falls, ID 83401-4337
Phone
(208) 529-0342
Fax
(208) 529-6981
NPI assigned
Apr 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6253804-3501 UT
Clinical Social Worker 1041C0700X 34353 ID Primary

Addresses

Primary practice location

1810 Moran St
Idaho Falls, ID 83401-4337

Mailing address

1810 Moran St
Idaho Falls, ID 83401-4337
Phone (208) 529-0342

Other practice location 1

433 S 500 E
American Fork, UT 84003-2527
Phone (801) 216-8000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mwilliams@hospiceofeasternidaho.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20170913000976 ID Practitioner - Clinical Social Worker 9335412352 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospice of Eastern Idaho, IncGroup PAC ID 8628087145, 2 clinicians

Practice addresses (Care Compare)

1810 Moran St
Idaho Falls, ID 83401-4337
Phone (208) 529-0342

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34353IDMDClinical Social Worker
6253804-3501UTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Hospice of Eastern Idaho, Inc. CurrentSince Aug 12, 2024 Accepting new patients
Hospice of Eastern Idaho, Inc. CurrentSince Aug 12, 2024 Accepting new patients

Locations

1810 Moran St
Idaho Falls, ID 83401
Phone (208) 529-0342

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": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1093930596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1810 MORAN ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834014337",
            "telephone_number": "208-529-0342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 MORAN ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834014337",
            "telephone_number": "208-529-0342",
            "fax_number": "208-529-6981"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "433 S 500 E",
            "address_purpose": "LOCATION",
            "city": "American Fork",
            "state": "UT",
            "postal_code": "840032527",
            "country_code": "US",
            "telephone_number": "801-216-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "MELISSA",
        "middle_name": "JANE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "6253804-3501",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "34353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mwilliams@hospiceofeasternidaho.com",
            "affiliation": "N",
            "address_1": "1810 Moran St",
            "city": "Idaho Falls",
            "state": "ID",
            "country_code": "US",
            "postal_code": "834014337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

Verify at the official NPI Registry.