Individual provider Active NPI

Michael Wayne Loftis, L.C.S.W.

  • Clinical Social Worker
  • Murfreesboro, TN
National Provider Identifier
1104906122
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3663 Issued in TN
Practice address
2670 Memorial Blvd
Suite E-2
Murfreesboro, TN 37129-5139
Phone
(615) 890-7946
Fax
(615) 890-7946
NPI assigned
Oct 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 3663 TN Primary

Addresses

Primary practice location

2670 Memorial Blvd
Suite E-2
Murfreesboro, TN 37129-5139

Mailing address

809 Rob LN
Lascassas, TN 37085-4635
Phone (615) 890-7946

Other identifiers 1

IdentifierTypeStateIssuer
3075520OtherTNBLUE CROSS BLUE SHIELD #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20060315000751 TN Practitioner - Clinical Social Worker 7012924087 Practice locations: Murfreesboro, TN

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2670 Memorial Blvd
E2
Murfreesboro, TN 37129-5134
Phone (615) 890-7946

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3663FLMDCounseling Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Paradigm Health Services, Inc Clinical Past Accepting new patients

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": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104906122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 ROB LN",
            "city": "LASCASSAS",
            "state": "TN",
            "postal_code": "370854635",
            "telephone_number": "615-890-7946",
            "fax_number": "615-890-7946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2670 MEMORIAL BLVD",
            "address_2": "SUITE E-2",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371295139",
            "telephone_number": "615-890-7946",
            "fax_number": "615-890-7946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOFTIS",
        "first_name": "MICHAEL",
        "middle_name": "WAYNE",
        "name_prefix": "Mr.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "3663",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD #",
            "identifier": "3075520",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Murfreesboro, TN

Sources for this page

Verify at the official NPI Registry.