Individual provider Active NPI

Pamela R. Brown-Anderson, LISW-S

  • Clinical Social Worker
  • Cincinnati, OH
National Provider Identifier
1174984710
Registry record updated Nov 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.1302884-SUPV Issued in OH
Practice address
311 Albert Sabin Way
Cincinnati, OH 45229-2838
Phone
(513) 558-3792
Fax
(513) 558-2701
NPI assigned
Mar 10, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2023

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 I.1302884-SUPV OH Primary

Addresses

Primary practice location

311 Albert Sabin Way
Cincinnati, OH 45229-2838

Mailing address

311 Albert Sabin Way
Cincinnati, OH 45229-2838
Phone (513) 558-3792

Other identifiers 1

IdentifierTypeStateIssuer
0204017MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20171025002544 OH Practitioner - Clinical Social Worker 7214203843 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

311 Albert Sabin Way
Cincinnati, OH 45229-2838
Phone (513) 558-9006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.1302884-SUPVOHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Central Clinic Outpatient Services Clinical CurrentSince Aug 27, 2017 Accepting new patients
Central Clinic Inc Mental Health Access Point Clinical Current Accepting new patients
Central Clinic Outpatient Services Clinical Current Accepting new patients

Locations

311 Albert Sabin Way
Cincinnati, OH 45229
Phone (513) 558-5823

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1457568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699488000000",
    "number": "1174984710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 ALBERT SABIN WAY",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452292838",
            "telephone_number": "513-558-3792",
            "fax_number": "513-558-2701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 ALBERT SABIN WAY",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452292838",
            "telephone_number": "513-558-3792",
            "fax_number": "513-558-2701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN-ANDERSON",
        "first_name": "PAMELA",
        "middle_name": "R.",
        "credential": "LISW-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-10",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1302884-SUPV",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0204017",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.