Active NPI
Justin Deremo
- Social Worker
- Bentonville, AR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 2508 SE 20TH St
Bentonville, AR 72712-4008 - Phone
- (479) 273-9088
- NPI assigned
- Jul 12, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | Primary |
Addresses
Primary practice location
2508 SE 20TH St
Bentonville, AR 72712-4008
Mailing address
2400 S 48TH St
Springdale, AR 72762-6683
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
2508 SE 20TH St
Bentonville, AR 72712-4008
Phone (479) 273-9088
401 S 40TH St
Rogers, AR 72756-1802
Phone (479) 273-9088
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ozark Guidance Center, Inc | Social Worker | Current | Accepting new patients |
| Ozark Guidance Center, Inc | Current | Accepting new patients |
Locations
2508 SE 20th St
Bentonville, AR 72712
Phone (479) 273-9088
1104 N College St
Huntsville, AR 72740
Phone (479) 738-2878
2400 S 48th St
Springdale, AR 72762
Phone (479) 725-5115
Organizations & group practices 3
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.
-
- Community/Behavioral Health Agency
- Springdale, AR
- NPI 1609875186
Social Worker
-
- Community/Behavioral Health Agency
- Springdale, AR
- NPI 1437750411
-
- Family Medicine Physician
- Springdale, AR
- NPI 1659945194
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1626048000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626048000000",
"number": "1306418124",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2400 S 48TH ST",
"city": "SPRINGDALE",
"state": "AR",
"postal_code": "727626683"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2508 SE 20TH ST",
"city": "BENTONVILLE",
"state": "AR",
"postal_code": "727124008",
"telephone_number": "479-273-9088"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEREMO",
"first_name": "JUSTIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-07-12",
"last_updated": "2021-07-12",
"certification_date": "2021-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bentonville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.