Individual provider Active NPI

Lindsay Poole

  • Clinical Social Worker
  • San Diego, CA
National Provider Identifier
1336927623
Registry record updated Sep 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
110506 Issued in CA
Practice address
3930 4TH Ave
San Diego, CA 92103-3119
Phone
(619) 542-9542
NPI assigned
Sep 18, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2023

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 110506 CA Primary

Addresses

Primary practice location

3930 4TH Ave
San Diego, CA 92103-3119

Mailing address

3930 4TH Ave
San Diego, CA 92103-3119

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
I20231130002513 CA Practitioner - Clinical Social Worker 1153779186 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Fordham University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthy Me Nursing, IncGroup PAC ID 8022494178, 10 clinicians

Practice addresses (Care Compare)

1446 Front St
Suite 400
San Diego, CA 92101-3425
Phone (619) 320-8711

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
110506CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Healthy Me Nursing, Inc CurrentSince Oct 17, 2023 Accepting new patients

Locations

1446 Front St
Ste 400
San Diego, CA 92101
Phone (619) 320-8711

3930 4th Ave
Ste 300
San Diego, CA 92103
Phone (619) 320-8711

Organizations & group practices 1

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": "1694995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1336927623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3930 4TH AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921033119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3930 4TH AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921033119",
            "telephone_number": "619-542-9542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POOLE",
        "first_name": "LINDSAY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-18",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "110506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.