Individual provider Active NPI

Nancy Jeanne Kotwicki, LMSW

  • Clinical Social Worker
  • Alpena, MI
National Provider Identifier
1275924037
Registry record updated Oct 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801095924 Issued in MI
Practice address
1501 W Chisholm St
Alpena, MI 49707-1401
Phone
(989) 356-7359
NPI assigned
Feb 13, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2015

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 6801095924 MI Primary

Addresses

Primary practice location

1501 W Chisholm St
Alpena, MI 49707-1401

Mailing address

1501 W Chisholm St
Alpena, MI 49707-1401
Phone (989) 356-7359

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20151208002217 MI Practitioner - Clinical Social Worker 5395045785 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mymichigan Medical Center AlpenaGroup PAC ID 8527969922, 97 clinicians

Practice addresses (Care Compare)

1501 W Chisholm St
Alpena, MI 49707-1401
Phone (989) 356-7242

Hospital & facility affiliations

  • Mymichigan Medical Center Alpena Hospital, Alpena, MI, CCN 230036

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801095924MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mymichigan Medical Center Alpena CurrentSince Oct 19, 2015 Accepting new patients
Mymichigan Medical Center Alpena Clinical CurrentSince Oct 19, 2015 Accepting new patients

Locations

1501 W Chisholm St
Alpena, MI 49707
Phone (989) 356-7000

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1423785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446163200000",
    "number": "1275924037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 W CHISHOLM ST",
            "city": "ALPENA",
            "state": "MI",
            "postal_code": "497071401",
            "telephone_number": "989-356-7359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 W CHISHOLM ST",
            "city": "ALPENA",
            "state": "MI",
            "postal_code": "497071401",
            "telephone_number": "989-356-7359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTWICKI",
        "first_name": "NANCY",
        "middle_name": "JEANNE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-13",
        "last_updated": "2015-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801095924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpena, MI

Sources for this page

Verify at the official NPI Registry.