Individual provider Active NPI

Gregory Solomon, LSW

  • Clinical Social Worker
  • Girard, OH
National Provider Identifier
1174159990
Registry record updated Feb 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
S.1700123 Issued in OH
Practice address
2722 W Liberty St
Girard, OH 44420-3116
Phone
(724) 396-1510
Fax
(724) 972-4627
NPI assigned
Mar 13, 2020
Last updated
Feb 22, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X S.1700123 OH Primary

Addresses

Primary practice location

2722 W Liberty St
Girard, OH 44420-3116

Mailing address

101 Pembroke CT
Greensburg, PA 15601-6404
Phone (724) 396-1510

Other practice location 1

4930 Enterprise Dr NW
Warren, OH 44481-8706
Phone (330) 787-0955

Other practice location 2

388 E Midlothian Blvd
Youngstown, OH 44507-1948
Phone (724) 396-1510

Other identifiers 1

IdentifierTypeStateIssuer
0394763MedicaidOH

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
S.1700123OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
FSR of Parkman LLC Single Specialty CurrentSince Sep 18, 2024 Accepting new patients
Richard Hoffman Single Specialty Past Accepting new patients
Richard Hoffman Clinical PastSince Feb 24, 2022 Accepting new patients

Locations

4930 Enterprise Dr NW
Warren, OH 44481
Phone 3303698022 ext. 153

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/parkmanrecovery/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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1584057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645488000000",
    "number": "1174159990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 PEMBROKE CT",
            "city": "GREENSBURG",
            "state": "PA",
            "postal_code": "156016404",
            "telephone_number": "724-396-1510",
            "fax_number": "724-972-4627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2722 W LIBERTY ST",
            "city": "GIRARD",
            "state": "OH",
            "postal_code": "444203116",
            "telephone_number": "724-396-1510",
            "fax_number": "724-972-4627"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4930 Enterprise Dr NW",
            "address_purpose": "LOCATION",
            "city": "Warren",
            "state": "OH",
            "postal_code": "444818706",
            "country_code": "US",
            "telephone_number": "330-787-0955",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "388 E Midlothian Blvd",
            "address_purpose": "LOCATION",
            "city": "Youngstown",
            "state": "OH",
            "postal_code": "445071948",
            "country_code": "US",
            "telephone_number": "724-396-1510",
            "fax_number": "724-972-4627",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOLOMON",
        "first_name": "GREGORY",
        "credential": "LSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-03-13",
        "last_updated": "2022-02-22",
        "certification_date": "2022-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "S.1700123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0394763",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Girard, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2022; 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.