Antoinette Shanae Nipper, LISW-CP

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

14879 Issued in SC

Practice address

105 Indigo Place CT
West Columbia, SC 29172-2698

Phone

(803) 974-9415

NPI assigned

Dec 20, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL, DC, NC, SC4 enrollments

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 4

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Healing Roots Therapy and Consulting Services LLC.

  • Clinical Social Worker
  • West Columbia, SC
  • NPI 1891448635
  Medicare reassignment NPD Authorized official
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Clinical, DC, NC, SC

  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1639958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1114687035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 INDIGO PLACE CT",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291722698",
            "telephone_number": "803-974-9415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 INDIGO PLACE CT",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291722698",
            "telephone_number": "803-974-9415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIPPER",
        "first_name": "ANTOINETTE",
        "middle_name": "SHANAE",
        "credential": "LISW-CP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-20",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "14879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly K Niermeier, CPNP
• Nitin Nigam, MD
• Elizabeth Bo Yung Nimmich, M.D.
• Matthew Charles Nimmich, D.M.D.
• Mitchell Lance Nimmich, MD
• Ashley Nix, FNP
• Clylinda Satanya Nixon, LMSW
• Emily Noble, PHARMD
• Kaitlyn Ann Nolan
• Lauren Riley Nordin, MD

• Clinical Social Worker in West Columbia, SC
• Providers in West Columbia, SC by specialty
• Clinical Social Worker in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.