Active NPI
Madison L Mahoney
- Social Worker
- Muncie, IN
National Provider Identifier
1437728060
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 99104463A
- Practice address
- 3620 W White River Blvd
Muncie, IN 47304-4286 - Phone
- (765) 288-1928
- NPI assigned
- Jun 18, 2021
- Last updated
- Jun 18, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 99104463A | IN | Primary |
Addresses
Primary practice location
3620 W White River Blvd
Muncie, IN 47304-4286
Mailing address
240 N Tillotson Ave
Muncie, IN 47304-3988
Phone (765) 288-1928
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 99104463A | IN | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623974400000",
"number": "1437728060",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "240 N TILLOTSON AVE",
"city": "MUNCIE",
"state": "IN",
"postal_code": "473043988",
"telephone_number": "765-288-1928"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3620 W WHITE RIVER BLVD",
"city": "MUNCIE",
"state": "IN",
"postal_code": "473044286",
"telephone_number": "765-288-1928"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAHONEY",
"first_name": "MADISON",
"middle_name": "L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-18",
"last_updated": "2021-06-18",
"certification_date": "2021-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "IN",
"license": "99104463A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Muncie, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.