Individual provider Active NPI

Garth Heasley, LISW

  • Social Worker
  • Columbus, OH
National Provider Identifier
1548647969
Registry record updated Jan 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
I.1700034 Issued in OH
Practice address
1943 W 5TH Ave
Columbus, OH 43212-1902
Phone
(614) 477-8257
NPI assigned
May 5, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X I.1700034 OH Primary

Addresses

Primary practice location

1943 W 5TH Ave
Columbus, OH 43212-1902

Mailing address

297 Ravine Ridge Dr N
Powell, OH 43065-9352

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
I20170223001902 OH Practitioner - Clinical Social Worker 5092099762 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

90 Northwoods Blvd
Suite B2
Columbus, OH 43235-4719
Phone (614) 477-8257

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.1700034OHMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Garth Heasley LLC CurrentSince Feb 14, 2017 Accepting new patients

Locations

1943 W 5th Ave
Columbus, OH 43212
Phone (614) 305-5102

90 Northwoods Blvd
Ste B2
Columbus, OH 43235
Phone (614) 477-8257

Organizations & group practices 1

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": "1430784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484870400000",
    "number": "1548647969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "297 RAVINE RIDGE DR N",
            "city": "POWELL",
            "state": "OH",
            "postal_code": "430659352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1943 W 5TH AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432121902",
            "telephone_number": "614-477-8257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEASLEY",
        "first_name": "GARTH",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-05-05",
        "last_updated": "2017-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "I.1700034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.