Active NPI
Georgetta Jean Hull, LCSW
- Clinical Social Worker
- Mexico, MO
National Provider Identifier
1215912571
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 2001024583
- Practice address
- 340 Kelley Pkwy
Mexico, MO 65265-3811 - Phone
- (573) 582-1234
- Fax
- (573) 582-1212
- NPI assigned
- Dec 9, 2005
- Last updated
- Jun 26, 2023
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 2001024583 | MO | Primary |
Addresses
Primary practice location
340 Kelley Pkwy
Mexico, MO 65265-3811
Mailing address
340 Kelley Pkwy
Mexico, MO 65265-3811
Phone (573) 582-1234
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2001024583 | Other | MS | MO. STATE LICENSE |
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)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Audrain Health Care, Inc | Past | Accepting new patients | |
| SSM Audrain Health Care, Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba SSM Health St. Mary's Hospital-Audrain
- General Acute Care Hospital
- Mexico, MO
- NPI 1841334836
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134086400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687737600000",
"number": "1215912571",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "340 KELLEY PKWY",
"city": "MEXICO",
"state": "MO",
"postal_code": "652653811",
"telephone_number": "573-582-1234",
"fax_number": "573-582-1212"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "340 KELLEY PKWY",
"city": "MEXICO",
"state": "MO",
"postal_code": "652653811",
"telephone_number": "573-582-1234",
"fax_number": "573-582-1212"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HULL",
"first_name": "GEORGETTA",
"middle_name": "JEAN",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-12-09",
"last_updated": "2023-06-26",
"certification_date": "2023-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MO",
"license": "2001024583",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MO. STATE LICENSE",
"identifier": "2001024583",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mexico, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.