Individual provider Active NPI

Judith Rhea Korn, LCSW

  • Clinical Social Worker
  • Bradenton, FL
National Provider Identifier
1346315561
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW SW0002609 Issued in FL
Practice address
6108 26TH St W
Bradenton, FL 34207-4474
Phone
(941) 718-9208
NPI assigned
Nov 22, 2006
Last updated
Oct 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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 LCSW SW0002609 FL Primary

Addresses

Primary practice location

6108 26TH St W
Bradenton, FL 34207-4474

Mailing address

6108 26TH St West
Suite 3B
Bradenton, FL 34207
Phone (941) 953-8515

Other practice location 1

6108 26th St West
Suite 3B
Bradenton, FL 34207
Phone (941) 953-8515

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20110303000805 FL Practitioner - Clinical Social Worker 8224210802 Practice locations: Bradenton, FL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6108 26TH St W
Bradenton, FL 34207-4474
Phone (941) 953-8515

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW SW0002609FLMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1346315561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6108 26TH ST WEST",
            "address_2": "SUITE 3B",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "34207",
            "telephone_number": "941-953-8515",
            "fax_number": "941-727-8120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6108 26TH ST W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342074474",
            "telephone_number": "941-718-9208"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6108 26th St West",
            "address_2": "Suite 3B",
            "address_purpose": "LOCATION",
            "city": "Bradenton",
            "state": "FL",
            "postal_code": "34207",
            "country_code": "US",
            "telephone_number": "941-953-8515",
            "fax_number": "941-727-8120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KORN",
        "first_name": "JUDITH",
        "middle_name": "RHEA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-22",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "LCSW SW0002609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.