Individual provider Active NPI

Susan G Schmitz, LISW, RPT-S

  • Clinical Social Worker
  • Coralville, IA
National Provider Identifier
1437159928
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
Practice address
1150 5TH St Ste 261
Coralville, IA 52241-2914
Phone
(319) 354-0786
Fax
(319) 358-6310
NPI assigned
Jul 26, 2005
Sex
Female
Sole proprietor
Yes

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 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
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
I20051215000891 IA Practitioner - Clinical Social Worker 9335160464 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Susan G Schmitz, Lisw, Inc Clinical CurrentSince Jun 16, 2006 Accepting new patients
Counseling and Health Center LLP PastSince Jul 1, 2006 Accepting new patients

Locations

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

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": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275004800000",
    "number": "1437159928",
    "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",
            "fax_number": "319-358-6310"
        },
        {
            "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",
            "fax_number": "319-358-6310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMITZ",
        "first_name": "SUSAN",
        "middle_name": "G",
        "credential": "LISW, RPT-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-26",
        "last_updated": "2010-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_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

Verify at the official NPI Registry.