Individual provider Active NPI

Samantha Forchione, LISW

  • Clinical Social Worker
  • Shelby, OH
National Provider Identifier
1184187817
Registry record updated Jan 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.2203943 Issued in OH
Practice address
2775 State Route 39
Shelby, OH 44875-9466
Phone
(419) 747-3322
NPI assigned
Apr 10, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X S.1600650 OH
Clinical Social Worker 1041C0700X I.2203943 OH Primary

Addresses

Primary practice location

2775 State Route 39
Shelby, OH 44875-9466

Mailing address

2775 State Route 39
Shelby, OH 44875-9466
Phone (419) 747-3322

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
I20240322003055 OH Practitioner - Clinical Social Worker 2264879428 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

525 Metro PL N
Suite 300
Dublin, OH 43017-5320
Phone (855) 289-1722

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S.1600650OHMDSocial Worker
I.2203943OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Cornell Abraxas Group, LLC PastSince Jun 21, 2022 Accepting new patients
Cornell Abraxas Group, LLC Past Accepting new patients

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": "1554854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673481600000",
    "number": "1184187817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2775 STATE ROUTE 39",
            "city": "SHELBY",
            "state": "OH",
            "postal_code": "448759466",
            "telephone_number": "419-747-3322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2775 STATE ROUTE 39",
            "city": "SHELBY",
            "state": "OH",
            "postal_code": "448759466",
            "telephone_number": "419-747-3322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORCHIONE",
        "first_name": "SAMANTHA",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-10",
        "last_updated": "2023-01-12",
        "certification_date": "2023-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.1600650",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2203943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby, OH

Sources for this page

Verify at the official NPI Registry.