Active NPI
Taryn Heath
- Social Worker
- Rensselaer, NY
National Provider Identifier
1114445244
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- P07671
- Practice address
- 620 Washington Ave
Rensselaer, NY 12144-1300 - Phone
- (607) 591-0528
- NPI assigned
- Sep 9, 2017
- 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 | P07671 | NY | Primary |
Addresses
Primary practice location
620 Washington Ave
Rensselaer, NY 12144-1300
Mailing address
4301 Stonegate Dr
Rensselaer, NY 12144-8305
Phone (607) 591-0528
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Nov 3, 2022 through Nov 3, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P07671 | NY | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eastern Door Licensed Clinical Social Work, PC | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Clinical Social Worker
- Rensselaer, NY
- NPI 1528500337
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1504915200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1504915200000",
"number": "1114445244",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4301 STONEGATE DR",
"city": "RENSSELAER",
"state": "NY",
"postal_code": "121448305",
"telephone_number": "607-591-0528"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "620 WASHINGTON AVE",
"city": "RENSSELAER",
"state": "NY",
"postal_code": "121441300",
"telephone_number": "607-591-0528"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEATH",
"first_name": "TARYN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-09-09",
"last_updated": "2017-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "P07671",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rensselaer, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.