Individual provider Active NPI

Johanna Kearley, MSW

  • Clinical Social Worker
  • Plant City, FL
National Provider Identifier
1487177218
Registry record updated Sep 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1001 E Baker St
Plant City, FL 33563-3700
Phone
(918) 521-8501
NPI assigned
Jul 24, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2020

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 Primary

Addresses

Primary practice location

1001 E Baker St
Plant City, FL 33563-3700

Mailing address

4422 E Columbus Dr
Tampa, FL 33605-3233
Phone (813) 384-4102

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20221004000527 FL Practitioner - Clinical Social Worker 8921484601 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1219 Millennium Pkwy
Brandon, FL 33511-3879
Phone (813) 451-2161

3457 Brook Crossing Dr
Brandon, FL 33511-8181
Phone (813) 451-2161

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bird in the Machine Clinical CurrentSince Dec 13, 2022 Accepting new patients
Heads Past Accepting new patients

Locations

1219 Millennium Pkwy
Brandon, FL 33511
Phone (813) 451-2161

3457 Brook Crossing Dr
Brandon, FL 33511
Phone (813) 655-5550

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": "1500854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600300800000",
    "number": "1487177218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4422 E COLUMBUS DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336053233",
            "telephone_number": "813-384-4102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 E BAKER ST",
            "city": "PLANT CITY",
            "state": "FL",
            "postal_code": "335633700",
            "telephone_number": "918-521-8501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEARLEY",
        "first_name": "JOHANNA",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-24",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plant City, FL

Sources for this page

Verify at the official NPI Registry.