NPIMap

Individual provider Active NPI

Jon Craig Reardon, LCSW

  • Clinical Social Worker
  • Tucson, AZ
National Provider Identifier
1437306362
Registry record updated Jun 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-11121 Issued in AZ
Practice address
5055 E Broadway Blvd Ste C-104
Tucson, AZ 85711-3641
Phone
(520) 571-6461
Fax
(520) 512-4056
NPI assigned
Aug 21, 2008
Sex
Male
Sole proprietor
Yes

Organizations & group practices 12

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.

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
United Community Health Center-Maria Auxiliadora, Inc 27 clinicians

Practice addresses (Care Compare)

15921 W Ajo Hwy
Tucson, AZ 85735-2032
Phone (520) 407-5700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131108001794 AZ Practitioner - Clinical Social Worker 0446485908 Reassigns benefits to 1 organization

All facility ownership & control disclosures 4

Medicare enrollment files

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Three Points ClinicTucson, AZ, CCN 031803 Federally qualified health center Corporate Officer (100%)
W-2 Managing Employee		 Jul 30, 2024
Jul 31, 2024
Uchc Dental for KidsGreen Valley, AZ, CCN 031869 Federally qualified health center Corporate Officer
W-2 Managing Employee		 Jul 30, 2024
Jul 30, 2024
Freeport McMoran Copper & Gold BuildingGreen Valley, AZ, CCN 031866 Federally qualified health center Corporate Officer
W-2 Managing Employee
Operational/Managerial Control		 Jul 30, 2024
Jul 30, 2024
Jul 30, 2024
La Canada Pediatrics Behavioral HealthSahuarita, AZ, CCN 031085 Federally qualified health center W-2 Managing Employee
Operational/Managerial Control		 Jul 31, 2024
Jul 31, 2024

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
United Community Health Center - Maria Auxiliadora, Inc. CurrentSince Aug 19, 2024 Accepting new patients
United Community Health Center-Maria Auxiliadora, Inc. CurrentSince Aug 19, 2024 Accepting new patients
Marana Health Center, Inc Past Accepting new patients

Locations

1260 S Campbell Ave
Green Valley, AZ 85614
Phone (520) 407-5600

1260 S Campbell Ave
Bldg 2
Green Valley, AZ 85614
Phone (520) 407-5400

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW-11121 AZ Primary

Addresses

NPPES NPI Registry

Primary practice location

5055 E Broadway Blvd Ste C-104
Tucson, AZ 85711-3641

Mailing address

5055 E Broadway Blvd Ste C-104
Tucson, AZ 85711-3641
Phone (520) 571-6461

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 17, 2013.

{
    "created_epoch": "1219276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371427200000",
    "number": "1437306362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5055 E BROADWAY BLVD STE C-104",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857113641",
            "telephone_number": "520-571-6461",
            "fax_number": "520-512-4056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5055 E BROADWAY BLVD STE C-104",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857113641",
            "telephone_number": "520-571-6461",
            "fax_number": "520-512-4056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REARDON",
        "first_name": "JON",
        "middle_name": "CRAIG",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-21",
        "last_updated": "2013-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-11121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.