Active NPI
Johnathan B South, LMSW
- Social Worker
- Earleville, MD
National Provider Identifier
1205572997
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 24025
- Practice address
- 314 Grove Neck Rd
Earleville, MD 21919-3008 - Phone
- (855) 740-1921
- NPI assigned
- May 6, 2022
- Last updated
- May 6, 2022
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 24025 | MD | Primary |
Addresses
Primary practice location
314 Grove Neck Rd
Earleville, MD 21919-3008
Mailing address
2701 Renaissance Blvd FL 4
King of Prussia, PA 19406-2781
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1651795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651795200000",
"number": "1205572997",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2701 RENAISSANCE BLVD FL 4",
"city": "KING OF PRUSSIA",
"state": "PA",
"postal_code": "194062781"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "314 GROVE NECK RD",
"city": "EARLEVILLE",
"state": "MD",
"postal_code": "219193008",
"telephone_number": "855-740-1921"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOUTH",
"first_name": "JOHNATHAN",
"middle_name": "B",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-05-06",
"last_updated": "2022-05-06",
"certification_date": "2022-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MD",
"license": "24025",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Earleville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 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.