Individual provider Active NPI

Brock Allan Bauer, LISW-S, SAP

  • Clinical Social Worker
  • Columbus, OH
National Provider Identifier
1407090897
Registry record updated Jan 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.0700102-SUPV Issued in OH
Practice address
929 Harrison Ave
304
Columbus, OH 43215-1346
Phone
(614) 940-4868
Fax
(614) 923-7525
NPI assigned
Apr 29, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 1, 2013

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 I.0700102-SUPV OH Primary

Addresses

Primary practice location

929 Harrison Ave
304
Columbus, OH 43215-1346

Mailing address

929 Harrison Ave
304
Columbus, OH 43215-1346
Phone (614) 940-4868

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20130322000065 OH Practitioner - Clinical Social Worker 5991940991 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Enliven Resources LLCGroup PAC ID 9537304530, 3 clinicians
Oh Independent Medical Group LLCGroup PAC ID 0648646034, 136 clinicians

Practice addresses (Care Compare)

929 Harrison Ave
Columbus, OH 43215-1300
Phone (614) 940-4868

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.0700102-SUPVOHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Oh Independent Medical Group LLC CurrentSince Sep 21, 2025 Accepting new patients
Enliven Health and Wellness LLC Clinical CurrentSince Aug 8, 2021 Accepting new patients
Oh Independent Medical Group LLC CurrentSince Sep 21, 2025 Accepting new patients

Locations

929 Harrison Ave
Ste 304
Columbus, OH 43215
Phone (614) 218-8769

929 Harrison Ave
Ste 200
Columbus, OH 43215
Phone (614) 940-4868

444 N Cleveland Ave
Ste 120
Westerville, OH 43082
Phone (614) 818-0300

Interoperability endpoints

  • Direct secure messaging: brock.bauer.1@26020.direct.athenahealth.com

Organizations & group practices 4

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": "1240963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356998400000",
    "number": "1407090897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "929 HARRISON AVE",
            "address_2": "304",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432151346",
            "telephone_number": "614-940-4868",
            "fax_number": "614-923-7525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "929 HARRISON AVE",
            "address_2": "304",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432151346",
            "telephone_number": "614-940-4868",
            "fax_number": "614-923-7525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUER",
        "first_name": "BROCK",
        "middle_name": "ALLAN",
        "credential": "LISW-S, SAP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-04-29",
        "last_updated": "2013-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.0700102-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.