Active NPI
Shelley Marie Patterson, MSW, LSW
- Social Worker
- Washington, IL
National Provider Identifier
1497498141
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 150.107306
- Practice address
- 1003 N Cummings LN
Washington, IL 61571-9646 - Phone
- (309) 444-1000
- NPI assigned
- Apr 19, 2022
- 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 | 150.107306 | IL | Primary |
Addresses
Primary practice location
1003 N Cummings LN
Washington, IL 61571-9646
Mailing address
1624 Kingsbury Rd
Washington, IL 61571-9261
Phone (309) 264-3233
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 |
|---|---|---|---|
| 150.107306 | IL | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1650326400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1650326400000",
"number": "1497498141",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1624 KINGSBURY RD",
"city": "WASHINGTON",
"state": "IL",
"postal_code": "615719261",
"telephone_number": "309-264-3233"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1003 N CUMMINGS LN",
"city": "WASHINGTON",
"state": "IL",
"postal_code": "615719646",
"telephone_number": "309-444-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATTERSON",
"first_name": "SHELLEY",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "MSW, LSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-04-19",
"last_updated": "2022-04-19",
"certification_date": "2022-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "IL",
"license": "150.107306",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 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.