Individual provider Active NPI

Earnest Webb Jr., MSW PHD

  • Clinical Social Worker
  • Homewood, IL
National Provider Identifier
1346370418
Registry record updated Oct 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149005899 Issued in IL
Practice address
849 Maple Ave.
903
Homewood, IL 60430-2068
Phone
(708) 799-5862
Fax
(708) 799-0138
NPI assigned
Mar 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2011

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 149005899 IL Primary

Addresses

Primary practice location

849 Maple Ave.
903
Homewood, IL 60430-2068

Mailing address

849 Maple Ave.
903
Homewood, IL 60430-2068
Phone (708) 799-5862

Other identifiers 2

IdentifierTypeStateIssuer
0001605394OtherILBLUE CROSS BLUE SHEILD #
182725OtherILVALUE OPTION PROVIDER #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20120103000064 IL Practitioner - Clinical Social Worker 7618014168 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

19516 Northwinds Dr
Lynwood, IL 60411-8660
Phone (708) 799-5862

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
149005899ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
More Abundant Living Institute, P.C. Clinical PastSince Sep 23, 2014 Accepting new patients

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": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320019200000",
    "number": "1346370418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "849 MAPLE AVE.",
            "address_2": "903",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604302068",
            "telephone_number": "708-799-5862",
            "fax_number": "708-799-0138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "849 MAPLE AVE.",
            "address_2": "903",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604302068",
            "telephone_number": "708-799-5862",
            "fax_number": "708-799-0138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBB",
        "first_name": "EARNEST",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MSW PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2011-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149005899",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD #",
            "identifier": "0001605394",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTION PROVIDER #",
            "identifier": "182725",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Homewood, IL

Sources for this page

Verify at the official NPI Registry.