Individual provider Active NPI

Shanda Barlow

  • Clinical Social Worker
  • Riverton, WY
National Provider Identifier
1124608088
Registry record updated Aug 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW1553 Issued in WY
Practice address
1035 Rose LN
Riverton, WY 82501-2291
Phone
(307) 463-7160
NPI assigned
Apr 13, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW1553 WY Primary
Mental Health Counselor 101YM0800X

Addresses

Primary practice location

1035 Rose LN
Riverton, WY 82501-2291

Mailing address

5000 Blackmore Rd
Casper, WY 82609-3345
Phone (307) 233-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230518001864 WY Practitioner - Clinical Social Worker 9638535503 Reassigns benefits to 1 organization
I20240923002622 TX Practitioner - Clinical Social Worker 9638535503 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW1553WYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Wind River Family & Community Healthc Care CurrentSince Sep 1, 2024 Accepting new patients
Community Health Center of Central Wyoming, Inc. Current Accepting new patients
Community Health Center of Central Wyoming Inc CurrentSince May 1, 2023 Accepting new patients

Locations

14 Great Plains Rd
Arapahoe, WY 82510

5000 Blackmore Rd
Casper, WY 82609
Phone (307) 233-6000

1035 Rose Ln
Riverton, WY 82501
Phone (307) 463-6300

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/3934/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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": "1618272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691971200000",
    "number": "1124608088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 BLACKMORE RD",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826093345",
            "telephone_number": "307-233-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 ROSE LN",
            "city": "RIVERTON",
            "state": "WY",
            "postal_code": "825012291",
            "telephone_number": "307-463-7160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARLOW",
        "first_name": "SHANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-13",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WY",
            "license": "LCSW1553",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverton, WY

Sources for this page

Verify at the official NPI Registry.