Individual provider Active NPI

Joann M Schmitz, LSW

  • Social Worker
  • Williston, ND
National Provider Identifier
1255417713
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
299 Issued in ND
Practice address
316 2ND Ave W
Williston, ND 58801-5218
Phone
(701) 774-4600
Fax
(701) 774-4620
NPI assigned
Oct 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 299 ND Primary

Addresses

Primary practice location

316 2ND Ave W
Williston, ND 58801-5218

Mailing address

PO Box 1266
Williston, ND 58802-1266
Phone (701) 774-4600

Other identifiers 1

IdentifierTypeStateIssuer
54516MedicaidND

Other names 1

  • Joann M Eccleston Former name

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
299NDMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255417713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1266",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "588021266",
            "telephone_number": "701-774-4600",
            "fax_number": "701-774-4620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 2ND AVE W",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "588015218",
            "telephone_number": "701-774-4600",
            "fax_number": "701-774-4620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMITZ",
        "first_name": "JOANN",
        "middle_name": "M",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ND",
            "license": "299",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "54516",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOANN",
            "last_name": "ECCLESTON",
            "middle_name": "M",
            "credential": "LSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Williston, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.