Individual provider Active NPI

Elizabeth R Anthony, LSW

  • Social Worker
  • Rocky River, OH
National Provider Identifier
1609499888
Registry record updated May 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
S.2004859 Issued in OH
Practice address
19035 Old Detroit Rd Ste 202
Rocky River, OH 44116-1750
Phone
(440) 638-5933
NPI assigned
May 22, 2020
Last updated
May 22, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2020

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 S.2004859 OH Primary

Addresses

Primary practice location

19035 Old Detroit Rd Ste 202
Rocky River, OH 44116-1750

Mailing address

2100 Lakeland Ave
Lakewood, OH 44107-5714
Phone (404) 323-6046

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
I20230308002764 OH Practitioner - Clinical Social Worker 7214300458 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Old River Associates LLCGroup PAC ID 3971846924, 2 clinicians

Practice addresses (Care Compare)

19035 Old Detroit Rd
Suite 201
Rocky River, OH 44116-1750
Phone (440) 668-5496

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S.2004859OHMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Old River Associates LLC CurrentSince Dec 1, 2022 Accepting new patients

Locations

19035 Old Detroit Rd
Ste 201
Rocky River, OH 44116
Phone (404) 323-6046

19035 Old Detroit Rd
Ste 202
Rocky River, OH 44116
Phone (440) 638-5933

19645 Progress Dr
Strongsville, OH 44149

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": "1590105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590105600000",
    "number": "1609499888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 LAKELAND AVE",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441075714",
            "telephone_number": "404-323-6046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19035 OLD DETROIT RD STE 202",
            "city": "ROCKY RIVER",
            "state": "OH",
            "postal_code": "441161750",
            "telephone_number": "440-638-5933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTHONY",
        "first_name": "ELIZABETH",
        "middle_name": "R",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-22",
        "last_updated": "2020-05-22",
        "certification_date": "2020-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.2004859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky River, OH

Sources for this page

Verify at the official NPI Registry.