Individual provider Active NPI

Malissa Higginbotham

  • Social Worker
  • Ashland, OH
National Provider Identifier
1275200750
Registry record updated Jun 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
S.2308983 Issued in OH
Practice address
2233 Rocky LN
Ashland, OH 44805-4701
Phone
(419) 281-3716
NPI assigned
Aug 24, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2024

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 S.2308983 OH Primary

Addresses

Primary practice location

2233 Rocky LN
Ashland, OH 44805-4701

Mailing address

2685 Armstrong Rd
Wooster, OH 44691-9041
Phone (330) 345-7949

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
S.2308983OHMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Christian Children'S Home of Ohio CurrentSince Aug 1, 2021 Accepting new patients
Christian Children'S Home of Ohio CurrentSince Aug 1, 2021 Accepting new patients

Locations

2685 Armstrong Rd
Wooster, OH 44691
Phone (330) 345-7949

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/cchoo/r4/

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": "1629763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1275200750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2685 ARMSTRONG RD",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446919041",
            "telephone_number": "330-345-7949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2233 ROCKY LN",
            "city": "ASHLAND",
            "state": "OH",
            "postal_code": "448054701",
            "telephone_number": "419-281-3716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIGGINBOTHAM",
        "first_name": "MALISSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-24",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.2308983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2024; 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.