Individual provider Active NPI

Michele Baiz, LISW-S

  • Clinical Social Worker
  • Springfield, OH
National Provider Identifier
1225573389
Registry record updated Oct 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.1700682 Issued in OH
Practice address
2213 N Limestone St
Springfield, OH 45503-2635
Phone
(937) 926-0113
NPI assigned
Dec 28, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2020

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 S1100481 OH
Clinical Social Worker 1041C0700X I.1700682 OH Primary

Addresses

Primary practice location

2213 N Limestone St
Springfield, OH 45503-2635

Mailing address

526 Gruen Dr
Springfield, OH 45505-2735
Phone (937) 926-0113

Other practice location 1

2213 N Limestone St
Springfield, OH 45503-2635
Phone (937) 926-0113

Other identifiers 1

IdentifierTypeStateIssuer
0256951MedicaidOH

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
I20181004001716 OH Practitioner - Clinical Social Worker 9931451895 Practice locations: Springfield, OH

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2213 N Limestone St
Springfield, OH 45503-2635
Phone (937) 926-0113

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S1100481OHMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1482883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603324800000",
    "number": "1225573389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "526 GRUEN DR",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455052735",
            "telephone_number": "937-926-0113",
            "fax_number": "937-342-4242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2213 N LIMESTONE ST",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455032635",
            "telephone_number": "937-926-0113"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2213 N Limestone St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "OH",
            "postal_code": "455032635",
            "country_code": "US",
            "telephone_number": "937-926-0113",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAIZ",
        "first_name": "MICHELE",
        "credential": "LISW-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-28",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S1100481",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1700682",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0256951",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OH

Sources for this page

Verify at the official NPI Registry.