Individual provider Active NPI

Corrie M. Vanamerongen, LISW

  • Clinical Social Worker
  • Columbus, OH
National Provider Identifier
1124403746
Registry record updated Oct 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.1501346 Issued in OH
Practice address
2300 W Broad St
Columbus, OH 43204-3783
Phone
(614) 645-2300
Fax
(614) 645-2333
NPI assigned
Jul 24, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2015

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.1302873 OH
Clinical Social Worker 1041C0700X I.1501346 OH Primary

Addresses

Primary practice location

2300 W Broad St
Columbus, OH 43204-3783

Mailing address

1800 Watermark Dr
Suite 420
Columbus, OH 43215-1048
Phone (614) 645-5500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S.1302873OHMDSocial Worker
I.1501346OHMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1437696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444262400000",
    "number": "1124403746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 WATERMARK DR",
            "address_2": "SUITE 420",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432151048",
            "telephone_number": "614-645-5500",
            "fax_number": "614-645-5517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 W BROAD ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432043783",
            "telephone_number": "614-645-2300",
            "fax_number": "614-645-2333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANAMERONGEN",
        "first_name": "CORRIE",
        "middle_name": "M.",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-24",
        "last_updated": "2015-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.1302873",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1501346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.