Individual provider Active NPI

Nancy Stevenson, LMSW

  • Social Worker
  • Traverse City, MI
National Provider Identifier
1366807281
Registry record updated Aug 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
680110446 Issued in FM
Practice address
5015 N Royal Dr
Traverse City, MI 49684-9292
Phone
(231) 935-0850
Fax
(231) 935-0869
NPI assigned
Dec 18, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Social Worker 104100000X 680110446 FM Primary

Addresses

Primary practice location

5015 N Royal Dr
Traverse City, MI 49684-9292

Mailing address

5015 N Royal Dr
Traverse City, MI 49684-9292
Phone (231) 935-0850

Other practice location 1

3644 Silver Farms Ln
Traverse City, MI 49684-8795
Phone (231) 409-5010

Other practice location 2

1844 Oak Hollow Dr
Traverse City, MI 49686-5924
Phone (231) 299-2149

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
I20230310001112 MI Practitioner - Clinical Social Worker 6204209356 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
680110446FMMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grand Traverse Internists, PC CurrentSince Oct 1, 2024 Accepting new patients

Locations

5015 N Royal Dr
Traverse City, MI 49684
Phone (231) 935-0850

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FIAHAA

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": "1450396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1366807281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5015 N ROYAL DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496849292",
            "telephone_number": "231-935-0850",
            "fax_number": "231-935-0869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5015 N ROYAL DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496849292",
            "telephone_number": "231-935-0850",
            "fax_number": "231-935-0869"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3644 Silver Farms Ln",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "496848795",
            "country_code": "US",
            "telephone_number": "231-409-5010",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1844 Oak Hollow Dr",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "496865924",
            "country_code": "US",
            "telephone_number": "231-299-2149",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEVENSON",
        "first_name": "NANCY",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-18",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "FM",
            "license": "680110446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.