Individual provider Active NPI

Edwina Gilmore, LISW

  • Clinical Social Worker
  • West Chester, OH
National Provider Identifier
1114389566
Registry record updated Jun 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.1800999 Issued in OH
Practice address
8904 Brookside Ave
West Chester, OH 45069
Phone
(513) 644-1030
Fax
(513) 644-1025
NPI assigned
Mar 24, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2018

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 I.1800999 OH Primary

Addresses

Primary practice location

8904 Brookside Ave
West Chester, OH 45069

Mailing address

8904 Brookside Ave
West Chester, OH 45069-3139
Phone (513) 644-1030

Other identifiers 1

IdentifierTypeStateIssuer
0263359MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20211120000243 OH Practitioner - Clinical Social Worker 2769871342 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital Medical Center CurrentSince Oct 14, 2021 Accepting new patients
Focus on Youth, Inc. Past 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 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": "1458777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529971200000",
    "number": "1114389566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8904 BROOKSIDE AVE",
            "city": "WEST CHESTER",
            "state": "OH",
            "postal_code": "450693139",
            "telephone_number": "513-644-1030",
            "fax_number": "513-644-1025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8904 BROOKSIDE AVE",
            "city": "WEST CHESTER",
            "state": "OH",
            "postal_code": "45069",
            "telephone_number": "513-644-1030",
            "fax_number": "513-644-1025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILMORE",
        "first_name": "EDWINA",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-24",
        "last_updated": "2018-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1800999",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0263359",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Chester, OH

Sources for this page

Verify at the official NPI Registry.