Individual provider Active NPI

Korah Hoffman, LMSW, MPA

  • Clinical Social Worker
  • Jackson, MI
National Provider Identifier
1396148581
Registry record updated Sep 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801097448 Issued in MI
Practice address
2652 Spring Arbor Rd
Jackson, MI 49203-3604
Phone
(607) 222-6518
NPI assigned
Oct 1, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2018

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 6801097448 MI Primary

Addresses

Primary practice location

2652 Spring Arbor Rd
Jackson, MI 49203-3604

Mailing address

2652 Spring Arbor Rd
Jackson, MI 49203-3604
Phone (517) 745-8682

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
I20170216000644 MI Practitioner - Clinical Social Worker 8022392315 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Flourish Center for Cultivating Human PotentialGroup PAC ID 2860776150, 4 clinicians

Practice addresses (Care Compare)

328 E Main St
Spring Arbor, MI 49283-9617
Phone (517) 745-8682

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801097448MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Flourish Center for Cultivating Human Potential Clinical CurrentSince Jan 19, 2017 Accepting new patients

Locations

328 E Main St
Spring Arbor, MI 49283
Phone (517) 745-8682

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": "1412121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537315200000",
    "number": "1396148581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2652 SPRING ARBOR RD",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492033604",
            "telephone_number": "517-745-8682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2652 SPRING ARBOR RD",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492033604",
            "telephone_number": "607-222-6518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOFFMAN",
        "first_name": "KORAH",
        "credential": "LMSW, MPA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-01",
        "last_updated": "2018-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801097448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.