Active NPI
Deborah L Hedges, LCSW
- Clinical Social Worker
- Evansville, IN
National Provider Identifier
1164771564
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 34007451A
- Practice address
- 4411 Washington Ave
Attn: Davina Jenkins
Evansville, IN 47714-0805 - Phone
- (812) 479-1916
- Fax
- (812) 479-5014
- NPI assigned
- Aug 31, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 34007451A | IN | Primary |
Addresses
Primary practice location
4411 Washington Ave
Attn: Davina Jenkins
Evansville, IN 47714-0805
Mailing address
4411 Washington Ave
Attn: Davina Jenkins
Evansville, IN 47714-0805
Phone (812) 479-1916
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200238820 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34007451A | IN | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grow Healthcare Group PA | Clinical | Current | Accepting new patients |
Locations
66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711
9465 Counselors Row
Ste 200
Indianapolis, IN 46240
Phone (463) 220-4646
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": "1346371200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1477526400000",
"number": "1164771564",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4411 WASHINGTON AVE",
"address_2": "ATTN: DAVINA JENKINS",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477140805",
"telephone_number": "812-479-1916",
"fax_number": "812-479-5014"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4411 WASHINGTON AVE",
"address_2": "ATTN: DAVINA JENKINS",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477140805",
"telephone_number": "812-479-1916",
"fax_number": "812-479-5014"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEDGES",
"first_name": "DEBORAH",
"middle_name": "L",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-08-31",
"last_updated": "2016-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IN",
"license": "34007451A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200238820",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Evansville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2016; 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.