Individual provider Active NPI

Nancy Ann Gilligan, MSW, LSW

  • Clinical Social Worker
  • Wauseon, OH
National Provider Identifier
1467841155
Registry record updated Jan 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
725 S Shoop Ave
Wauseon, OH 43567-1702
Phone
(419) 337-8661
Fax
(419) 330-2774
NPI assigned
Jan 18, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X S.1450920 OH
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

725 S Shoop Ave
Wauseon, OH 43567-1702

Mailing address

725 S Shoop Ave
Wauseon, OH 43567-1702
Phone (419) 330-2790

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
I20200608002985 OH Practitioner - Clinical Social Worker 6901227412 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
FCHC Medical Care, LLCGroup PAC ID 8022018704, 58 clinicians

Practice addresses (Care Compare)

725 S Shoop Ave
Wauseon, OH 43567-1701
Phone (419) 335-2015

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S.1450920OHMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
FCHC Medical Care, LLC CurrentSince Jun 15, 2020 Accepting new patients

Locations

L3493
Columbus, OH 43260

L4133
Columbus, OH 43260

725 S Shoop Ave
Wauseon, OH 43567
Phone (419) 335-2015

495 S Shoop Ave
Wauseon, OH 43567
Phone (419) 330-2790

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": "1421539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705449600000",
    "number": "1467841155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 S SHOOP AVE",
            "city": "WAUSEON",
            "state": "OH",
            "postal_code": "435671702",
            "telephone_number": "419-330-2790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 S SHOOP AVE",
            "city": "WAUSEON",
            "state": "OH",
            "postal_code": "435671702",
            "telephone_number": "419-337-8661",
            "fax_number": "419-330-2774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLIGAN",
        "first_name": "NANCY",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "MSW, LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-18",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.1450920",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauseon, OH

Sources for this page

Verify at the official NPI Registry.