Individual provider Active NPI

Susan Marie Ridenour, LSCSW

  • Clinical Social Worker
  • Lawrence, KS
National Provider Identifier
1154449510
Registry record updated Nov 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1252 Issued in KS
Practice address
300 Illinois St
Lawrence, KS 66044-1341
Phone
(785) 312-0537
NPI assigned
Mar 26, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2016

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 1252 KS Primary

Addresses

Primary practice location

300 Illinois St
Lawrence, KS 66044-1341

Mailing address

300 Illinois St
Lawrence, KS 66044-1341
Phone (785) 312-0537

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, KS2 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
I20211202001323 MO Practitioner - Clinical Social Worker 1557751773 Reassigns benefits to 1 organization
I20211202001406 KS Practitioner - Clinical Social Worker 1557751773 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
91.16 of 100Reported as group
Quality
80.99
Improvement activities
40
Cost
72.05

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1252KSMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Deer Oaks Mental Health Associates PC CurrentSince Dec 1, 2021 Accepting new patients

Locations

7101 E 21st St N
Wichita, KS 67206
Phone (316) 682-8909

1300 County Farm Rd
Cassville, MO 65625
Phone (417) 847-3386

7272 Wurzbach Rd
Ste 601
San Antonio, TX 78240
Phone (210) 615-3472

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478649600000",
    "number": "1154449510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 ILLINOIS ST",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660441341",
            "telephone_number": "785-312-0537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 ILLINOIS ST",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660441341",
            "telephone_number": "785-312-0537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDENOUR",
        "first_name": "SUSAN",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LSCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2016-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "1252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, KS

Sources for this page

Verify at the official NPI Registry.