Individual provider Active NPI

Elijah Tussing, LMSW, CSW-I

  • Clinical Social Worker
  • Carson City, NV
National Provider Identifier
1609480599
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
IC-2247 Issued in NV
Practice address
775 Fleischmann Way
Carson City, NV 89703-2995
Phone
(775) 445-9172
NPI assigned
Sep 8, 2020
Last updated
Aug 10, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Clinical Social Worker 1041C0700X IC-2247 NV Primary

Addresses

Primary practice location

775 Fleischmann Way
Carson City, NV 89703-2995

Mailing address

775 Fleischmann Way
Carson City, NV 89703-2995
Phone (775) 445-7773

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20260508001631 NV Practitioner - Clinical Social Worker 7214405174 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1600 Medical Pkwy
Carson City, NV 89703-4625

PO Box
Suite 2168
Carson City, NV 89702

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
IC-2247NVMDClinical Social Worker

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, 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": "1599523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1609480599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "775 FLEISCHMANN WAY",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897032995",
            "telephone_number": "775-445-7773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 FLEISCHMANN WAY",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897032995",
            "telephone_number": "775-445-9172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUSSING",
        "first_name": "ELIJAH",
        "credential": "LMSW, CSW-I",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-08",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "IC-2247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carson City, NV

Sources for this page

Verify at the official NPI Registry.