Individual provider Active NPI

Grace Ivey, MSW

  • Clinical Social Worker
  • San Francisco, CA
National Provider Identifier
1265698369
Registry record updated Jul 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1001 Potrero Ave
Suite 7M
San Francisco, CA 94110-3518
Phone
(415) 206-5397
NPI assigned
Jul 29, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

1001 Potrero Ave
Suite 7M
San Francisco, CA 94110-3518

Mailing address

995 Potrero Ave
San Francisco, CA 94110-2859

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20170109000204 CA Practitioner - Clinical Social Worker 5991086845 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mendocino Community Health Clinic IncGroup PAC ID 6305755455, 57 clinicians

Practice addresses (Care Compare)

333 Laws Ave
Ukiah, CA 95482-6540
Phone (458) 292-2167

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
74067CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Mendocino Community Health Clinic, Inc. CurrentSince Jan 1, 2017 Accepting new patients
Mendocino Community Health Clinic, Inc. CurrentSince Jan 1, 2017 Accepting new patients

Locations

333 Laws Ave
Ukiah, CA 95482
Phone (707) 463-1113

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1217289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342396800000",
    "number": "1265698369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "995 POTRERO AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941102859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 POTRERO AVE",
            "address_2": "SUITE 7M",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941103518",
            "telephone_number": "415-206-5397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVEY",
        "first_name": "GRACE",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-29",
        "last_updated": "2012-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.