Active NPI
Amanda Victoria Wilson-Blevens
- Social Worker
- Pepper Pike, OH
National Provider Identifier
1609501857
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 000583439
- Practice address
- 3737 Lander Rd
Pepper Pike, OH 44124-5712 - Phone
- (216) 831-2255
- NPI assigned
- Jul 21, 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 | 000583439 | OH | Primary |
Addresses
Primary practice location
3737 Lander Rd
Pepper Pike, OH 44124-5712
Mailing address
6780 Mayfield Rd
Mayfield Heights, OH 44124-2203
Phone (440) 312-4500
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 |
|---|---|---|---|
| 000583439 | OH | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1658361600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1700006400000",
"number": "1609501857",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6780 MAYFIELD RD",
"city": "MAYFIELD HEIGHTS",
"state": "OH",
"postal_code": "441242203",
"telephone_number": "440-312-4500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3737 LANDER RD",
"city": "PEPPER PIKE",
"state": "OH",
"postal_code": "441245712",
"telephone_number": "216-831-2255"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON-BLEVENS",
"first_name": "AMANDA",
"middle_name": "VICTORIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-07-21",
"last_updated": "2023-11-15",
"certification_date": "2023-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OH",
"license": "000583439",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pepper Pike, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.