NPIMap

Individual provider Active NPI

Tabatha Jo Baumgartner, LCSW

  • Clinical Social Worker
  • Rupert, ID
National Provider Identifier
1225569338
Registry record updated Sep 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-44878 Issued in ID
Practice address
512 6TH St
Rupert, ID 83350-1621
Phone
(208) 436-4911
Fax
(208) 436-1758
NPI assigned
Mar 22, 2017
Last updated
Sep 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2024

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 LMSW-36530 ID
Clinical Social Worker 1041C0700X LCSW-44878 ID Primary

Addresses

Primary practice location

512 6TH St
Rupert, ID 83350-1621

Mailing address

402 6TH St
Rupert, ID 83350-1619
Phone (208) 650-7941

Other names 1

  • Tabatha Jo Carson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240513001395 ID Practitioner - Clinical Social Worker 7012336357 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

402 6TH St
Rupert, ID 83350-1619
Phone (208) 650-7941

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMSW-36530IDMDSocial Worker
LCSW-44878IDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Services Corporation Clinical Current Accepting new patients
Family Health Services Corporation Current Accepting new patients
A Time for Change Therapy Clinical Current Accepting new patients
Family Health Services Corporation Clinical CurrentSince Mar 26, 2024 Accepting new patients
Family Health Services Corporation Clinical Current Accepting new patients
Family Health Services Corporation Social Worker CurrentSince Mar 26, 2024 Accepting new patients
Family Health Services Corporation Social Worker Past Accepting new patients
Family Health Services Corporation Social Worker Past Accepting new patients
Family Health Services Corporation Past Accepting new patients
Family Health Services Corporation Clinical Past Accepting new patients
Family Health Services Corporation Social Worker Past Accepting new patients
Family Health Services Corporation Social Worker Past Accepting new patients

Locations

725 Fair St
Buhl, ID 83316
Phone (208) 543-8271

1309 Bennett Ave
Burley, ID 83318
Phone (208) 677-5198

218 W Nez Perce
Jerome, ID 83338
Phone (208) 324-3471

402 6th St
Rupert, ID 83350
Phone (208) 650-7941

325 Martin St
Twin Falls, ID 83301
Phone (208) 732-7101

388 Martin St
Twin Falls, ID 83301
Phone (208) 734-0451

794 Eastland Dr
Twin Falls, ID 83301
Phone (208) 734-3312

Interoperability endpoints

  • Direct secure messaging: tabitha.baumgartnerlmsw.p1@direct.fhsid.nextgenshare.com

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1490140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725494400000",
    "number": "1225569338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 6TH ST",
            "city": "RUPERT",
            "state": "ID",
            "postal_code": "833501619",
            "telephone_number": "208-650-7941",
            "fax_number": "208-436-0735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 6TH ST",
            "city": "RUPERT",
            "state": "ID",
            "postal_code": "833501621",
            "telephone_number": "208-436-4911",
            "fax_number": "208-436-1758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUMGARTNER",
        "first_name": "TABATHA",
        "middle_name": "JO",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-22",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ID",
            "license": "LMSW-36530",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW-44878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TABATHA",
            "last_name": "CARSON",
            "middle_name": "JO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rupert, ID

Sources for this page

Verify at the official NPI Registry.