Individual provider Active NPI

James C. Simon, LICSW

  • Clinical Social Worker
  • North Kingstown, RI
National Provider Identifier
1538477708
Registry record updated Sep 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ISW01580 Issued in RI
Practice address
1130 Ten Rod Rd
Building C201
North Kingstown, RI 02852-4161
Phone
(401) 721-5657
Fax
(401) 294-7773
NPI assigned
Sep 21, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2010

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 ISW01580 RI Primary

Addresses

Primary practice location

1130 Ten Rod Rd
Building C201
North Kingstown, RI 02852-4161

Mailing address

1130 Ten Rod Rd
Building C201
North Kingstown, RI 02852-4161
Phone (401) 721-5657

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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
I20110203000440 RI Practitioner - Clinical Social Worker 6103006408 Reassigns benefits to 1 organization
Practice locations: North Kingstown, RI

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ISW01580RIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Perspectives Corporation Clinical CurrentSince Dec 11, 2012 Accepting new patients
Perspectives Corporation Past Accepting new patients

Locations

1130 Ten Rod Rd
Ste C102
North Kingstown, RI 02852
Phone (401) 294-3990

1130 Ten Rod Rd
Ste B101
North Kingstown, RI 02852
Phone (401) 294-3990

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, 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": "1285027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285027200000",
    "number": "1538477708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 TEN ROD RD",
            "address_2": "BUILDING C201",
            "city": "NORTH KINGSTOWN",
            "state": "RI",
            "postal_code": "028524161",
            "telephone_number": "401-721-5657",
            "fax_number": "401-294-7773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 TEN ROD RD",
            "address_2": "BUILDING C201",
            "city": "NORTH KINGSTOWN",
            "state": "RI",
            "postal_code": "028524161",
            "telephone_number": "401-721-5657",
            "fax_number": "401-294-7773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "JAMES",
        "middle_name": "C.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-21",
        "last_updated": "2010-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "ISW01580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Kingstown, RI

Sources for this page

Verify at the official NPI Registry.