Individual provider Active NPI

Monique Phifer, LSW

  • Social Worker
  • Columbus, OH
National Provider Identifier
1215235312
Registry record updated Mar 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
S.1000955 Issued in OH
Practice address
655 E Livingston Ave
Columbus, OH 43205-2618
Phone
(614) 722-8212
Fax
(614) 722-8422
NPI assigned
Mar 14, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X S.1000955 OH Primary

Addresses

Primary practice location

655 E Livingston Ave
Columbus, OH 43205-2618

Mailing address

PO Box 715194
Columbus, OH 43271-5194
Phone (614) 355-8004

Other identifiers 1

IdentifierTypeStateIssuer
08258MedicaidOH

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
I20220321000592 OH Practitioner - Clinical Social Worker 6608261102

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S.1000955OHMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1300060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300060800000",
    "number": "1215235312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 715194",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432715194",
            "telephone_number": "614-355-8004",
            "fax_number": "614-355-0509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 E LIVINGSTON AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432052618",
            "telephone_number": "614-722-8212",
            "fax_number": "614-722-8422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHIFER",
        "first_name": "MONIQUE",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-14",
        "last_updated": "2011-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.1000955",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08258",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.