Individual provider Active NPI

Jordan Thurman, LISW-S

  • Clinical Social Worker
  • Bellefontaine, OH
National Provider Identifier
1497295885
Registry record updated Jul 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.1600215 Issued in OH
Practice address
212 E Columbus Ave Ste 1
Bellefontaine, OH 43311
Phone
(937) 599-1411
Fax
(937) 599-4128
NPI assigned
Mar 3, 2017
Last updated
Jul 1, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2019

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 I.1600215 OH Primary

Addresses

Primary practice location

212 E Columbus Ave Ste 1
Bellefontaine, OH 43311

Mailing address

4879 US Highway 68 S
West Liberty, OH 43357-9525
Phone (937) 599-1411

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
I20170712002608 OH Practitioner - Clinical Social Worker 4183993884 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Positive Perspectives IncGroup PAC ID 8527952696, 7 clinicians

Practice addresses (Care Compare)

4949 Urbana Rd
Suite 201
Springfield, OH 45502-8387
Phone (937) 390-3800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.1600215OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Positive Perspectives, Inc. Clinical CurrentSince Feb 21, 2023 Accepting new patients
Mindfully, LLC Clinical CurrentSince Sep 2, 2021 Accepting new patients
Mindfully, LLC CurrentSince Sep 2, 2021 Accepting new patients

Locations

566 E Dayton Yellow Springs Rd
Fairborn, OH 45324
Phone (937) 390-3800

1251 Nilles Rd
Ste 5
Fairfield, OH 45014
Phone (732) 993-4599

4949 Urbana Rd
Springfield, OH 45502
Phone (937) 390-3800

4949 Urbana Rd
Ste 201
Springfield, OH 45502
Phone (937) 390-3800

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1488499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561939200000",
    "number": "1497295885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4879 US HIGHWAY 68 S",
            "city": "WEST LIBERTY",
            "state": "OH",
            "postal_code": "433579525",
            "telephone_number": "937-599-1411",
            "fax_number": "937-599-4128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 E COLUMBUS AVE STE 1",
            "city": "BELLEFONTAINE",
            "state": "OH",
            "postal_code": "43311",
            "telephone_number": "937-599-1411",
            "fax_number": "937-599-4128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THURMAN",
        "first_name": "JORDAN",
        "name_prefix": "Mrs.",
        "credential": "LISW-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-03",
        "last_updated": "2019-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1600215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellefontaine, OH

Sources for this page

Verify at the official NPI Registry.