Individual provider Active NPI

Britney Shale Bruce, LISW-S

  • Social Worker
  • Cincinnati, OH
National Provider Identifier
1104343136
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
I.2203667 Issued in OH
Practice address
4179 Ebenezer Rd
Cincinnati, OH 45248-1505
Phone
(513) 574-1205
Fax
(513) 574-1206
NPI assigned
Aug 30, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X S.1701041 OH
Social Worker 104100000X I.2203667 OH Primary

Addresses

Primary practice location

4179 Ebenezer Rd
Cincinnati, OH 45248-1505

Mailing address

4179 Ebenezer Rd
Cincinnati, OH 45248-1505
Phone (513) 574-1205

Other names 1

  • Britney Shale Alexander Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: No
  • 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
I20230825001085 OH Practitioner - Clinical Social Worker 6608239553 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S.1701041OHMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital Medical Center Social Worker CurrentSince Jul 13, 2023 Accepting new patients

Locations

3341 Solutions Ctr
Chicago, IL 60677

3333 Burnet Ave
Cincinnati, OH 45229
Phone (513) 636-4200

3333 Burnet Ave
#5021
Cincinnati, OH 45229
Phone (513) 636-4225

Organizations & group practices 1

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": "1504051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1104343136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4179 EBENEZER RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452481505",
            "telephone_number": "513-574-1205",
            "fax_number": "513-574-1206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4179 EBENEZER RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452481505",
            "telephone_number": "513-574-1205",
            "fax_number": "513-574-1206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUCE",
        "first_name": "BRITNEY",
        "middle_name": "SHALE",
        "name_prefix": "Mrs.",
        "credential": "LISW-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-30",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.1701041",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "I.2203667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRITNEY",
            "last_name": "ALEXANDER",
            "middle_name": "SHALE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.