Individual provider Active NPI

Rhonda Johnson, LMSW

  • Social Worker
  • Ottumwa, IA
National Provider Identifier
1154793446
Registry record updated Oct 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
076613 Issued in IA
Practice address
110 E Main St
Ottumwa, IA 52501-2910
Phone
(641) 682-8772
Fax
(641) 682-1924
NPI assigned
Oct 26, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 076613 IA Primary

Addresses

Primary practice location

110 E Main St
Ottumwa, IA 52501-2910

Mailing address

110 E Main St
Ottumwa, IA 52501-2910
Phone (641) 682-8772

Other identifiers 2

IdentifierTypeStateIssuer
1659353670MedicaidIA
1659353670OtherIABLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20180124000505 IA Practitioner - Clinical Social Worker 7517226350 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Southern California Keck School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1527 Albia Rd
Ottumwa, IA 52501-3907
Phone (641) 682-8772

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
076613IAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Iowa Mental Health Center CurrentSince Jan 21, 2018 Accepting new patients
Southern Iowa Mental Health Center CurrentSince Jan 21, 2018 Accepting new patients

Locations

1527 Albia Rd
Ottumwa, IA 52501
Phone (641) 682-8772

110 E Main St
Ottumwa, IA 52501
Phone (641) 682-8772

Organizations & group practices 2

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": "1445817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445817600000",
    "number": "1154793446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 E MAIN ST",
            "city": "OTTUMWA",
            "state": "IA",
            "postal_code": "525012910",
            "telephone_number": "641-682-8772",
            "fax_number": "641-682-1924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E MAIN ST",
            "city": "OTTUMWA",
            "state": "IA",
            "postal_code": "525012910",
            "telephone_number": "641-682-8772",
            "fax_number": "641-682-1924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "RHONDA",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-26",
        "last_updated": "2015-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IA",
            "license": "076613",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1659353670",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1659353670",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ottumwa, IA

Sources for this page

Verify at the official NPI Registry.