Organization Active NPI

Susan G Schmitz, Lisw, Inc

  • Clinical Social Worker
  • Coralville, IA
National Provider Identifier
1386698587
Registry record updated May 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
02299 Issued in IA
Legal business name
SUSAN G SCHMITZ, LISW, INC
Practice address
1150 5TH St Ste 261
Coralville, IA 52241-2914
Phone
(319) 354-0786
NPI assigned
May 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2010

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

Authorized official

Name
Susan G Schmitz, LISWNPI 1437159928
Title
President/Owner
Phone
(319) 354-0786

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 02299 IA Primary

Addresses

Primary practice location

1150 5TH St Ste 261
Coralville, IA 52241-2914

Mailing address

1150 5TH St Ste 261
Coralville, IA 52241-2914
Phone (319) 354-0786

Other identifiers 1

IdentifierTypeStateIssuer
473130000MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060627000163 IA Part B Supplier - Clinic/Group Practice 3274545744 Receives reassigned benefits from 1 practitioner
Practice locations: Iowa City, IA

National Provider Directory

National Provider Directory

Locations

1150 5th St
Ste 261
Coralville, IA 52241
Phone (319) 338-3862

623 S Dubuque St
Iowa City, IA 52240

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275004800000",
    "number": "1386698587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 5TH ST STE 261",
            "city": "CORALVILLE",
            "state": "IA",
            "postal_code": "522412914",
            "telephone_number": "319-354-0786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 5TH ST STE 261",
            "city": "CORALVILLE",
            "state": "IA",
            "postal_code": "522412914",
            "telephone_number": "319-354-0786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN G SCHMITZ, LISW, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-20",
        "last_updated": "2010-05-28",
        "status": "A",
        "authorized_official_last_name": "SCHMITZ",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "319-354-0786",
        "authorized_official_credential": "LISW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "02299",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "473130000",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coralville, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.