Individual provider Active NPI

Niny Fernanda Rosso-Reyes, LSW

  • Clinical Social Worker
  • Columbus, OH
National Provider Identifier
1225521875
Registry record updated Oct 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.1901829 Issued in OH
Practice address
2300 W. Broad Street
Columbus, OH 43204-3783
Phone
(614) 645-2300
Fax
(614) 645-2333
NPI assigned
Jun 8, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X S1500381 OH
Clinical Social Worker 1041C0700X I.1901829 OH Primary

Addresses

Primary practice location

2300 W. Broad Street
Columbus, OH 43204-3783

Mailing address

2780 Airport Dr Ste 100
Columbus, OH 43219-2289
Phone (614) 859-1906

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
I20191118003231 OH Practitioner - Clinical Social Worker 9436581105 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S1500381OHMDMental Health Counselor
I.1901829OHMDClinical Social Worker

Organizations & group practices 1

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": "1528416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570665600000",
    "number": "1225521875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2780 AIRPORT DR STE 100",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432192289",
            "telephone_number": "614-859-1906",
            "fax_number": "614-645-5517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 W. BROAD STREET",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432043783",
            "telephone_number": "614-645-2300",
            "fax_number": "614-645-2333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSSO-REYES",
        "first_name": "NINY",
        "middle_name": "FERNANDA",
        "name_prefix": "Mrs.",
        "credential": "LSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-08",
        "last_updated": "2019-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "S1500381",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1901829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.