Individual provider Active NPI

Georgia Shumpert

  • Clinical Social Worker
  • Maple Heights, OH
National Provider Identifier
1497484208
Registry record updated Jun 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.2203495 Issued in OH
Practice address
14413 Reddington Ave
Maple Heights, OH 44137-3213
Phone
(216) 337-5859
NPI assigned
Jun 7, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X I.2203495 OH Primary

Addresses

Primary practice location

14413 Reddington Ave
Maple Heights, OH 44137-3213

Mailing address

14413 Reddington Ave
Maple Heights, OH 44137-3213
Phone (216) 337-5859

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

LicenseStateTypeSpecialty
I.2203495OHMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1654560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654560000000",
    "number": "1497484208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14413 REDDINGTON AVE",
            "city": "MAPLE HEIGHTS",
            "state": "OH",
            "postal_code": "441373213",
            "telephone_number": "216-337-5859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14413 REDDINGTON AVE",
            "city": "MAPLE HEIGHTS",
            "state": "OH",
            "postal_code": "441373213",
            "telephone_number": "216-337-5859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUMPERT",
        "first_name": "GEORGIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-07",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2203495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maple Heights, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.