Panankosi Mbunjwa, LLMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801096352 Issued in MI

Practice address

1485 S M-139
Benton Harbor, MI 49022

Phone

(269) 925-0585

Fax

(269) 927-1326

NPI assigned

Mar 6, 2014

Last updated

Mar 6, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Clinical Social Worker

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Berrien Mental Health AuthorityGroup PAC ID 0345223707, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Berrien Mental Health Authority

  dba Riverwood Center

  • Psychiatry Physician
  • Benton Harbor, MI
  • NPI 1033280763

  Social Worker

  Medicare reassignment Care Compare group NPD
• Berrien Mental Health Authority

  dba NorthStar Center

  • Psychiatry Physician
  • Saint Joseph, MI
  • NPI 1508801465
  NPD

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

{
    "created_epoch": "1394064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394064000000",
    "number": "1174949796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1485 S M-139",
            "city": "BENTON HARBOR",
            "state": "MI",
            "postal_code": "49022",
            "telephone_number": "269-925-0585",
            "fax_number": "269-927-1326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1485 S M-139",
            "city": "BENTON HARBOR",
            "state": "MI",
            "postal_code": "49022",
            "telephone_number": "269-925-0585",
            "fax_number": "269-927-1326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MBUNJWA",
        "first_name": "PANANKOSI",
        "name_prefix": "Mr.",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-06",
        "last_updated": "2014-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801096352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shamika Mason
• Maternal Support Services
• Caden J Mattingly
• Deborah Matwetwe, FNP
• Arturo S Maxwell, PHD IN PROGRESS
• Aryenne Hali McCarver
• Micah McCree-Davis
• Autumn McCune
• Daniel Rupert McGinn, D.D.S.
• Vonetta Reshan McGinnis, MSW

• Clinical Social Worker in Benton Harbor, MI
• Providers in Benton Harbor, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2014; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.