William Anthony Mathis, LCSW, CADC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

3320 Issued in KY

Practice address

517 Little League Blvd
Clarksville, IN 47129-6629

Phone

(888) 948-6789

Fax

(877) 345-3501

NPI assigned

Dec 16, 2009

Last updated

Oct 29, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in KY, IN2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Onhealthcare, LLC

  dba OnHealthcare Optometry

  • Optometrist
  • Indianapolis, IN
  • NPI 1417220369
  Medicare reassignment NPD
• 360Care Services of Kentucky LLC

  • Social Worker
  • Louisville, KY
  • NPI 1669113023

  Clinical

  Medicare reassignment NPD
• PPL Therapeutic Services PLLC

  • Professional Counselor
  • Crestwood, KY
  • NPI 1104323252

  Clinical

  Medicare reassignment NPD
• T Mathis Development LLC

  • Clinical Social Worker
  • Clarksville, IN
  • NPI 1932672797
  NPD Authorized official
• Onhealthcare LLC

  • Social Worker
  • Indianapolis, IN
  • NPI 1114681681

  Clinical

  NPD
• 360Care Services of Kentucky LLC

  • Nurse Practitioner
  • Louisville, KY
  • NPI 1174394852
  NPD
• Onhealthcare LLC

  dba OnHealthcare Podiatry

  • Podiatrist
  • Indianapolis, IN
  • NPI 1952677353
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1260921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540771200000",
    "number": "1639408990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3907 ELGIN WAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402164908",
            "telephone_number": "502-778-2006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 LITTLE LEAGUE BLVD",
            "city": "CLARKSVILLE",
            "state": "IN",
            "postal_code": "471296629",
            "telephone_number": "888-948-6789",
            "fax_number": "877-345-3501"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3907 Elgin Way",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402164908",
            "country_code": "US",
            "telephone_number": "502-778-2006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATHIS",
        "first_name": "WILLIAM",
        "middle_name": "ANTHONY",
        "name_prefix": "Mr.",
        "credential": "LCSW, CADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-12-16",
        "last_updated": "2018-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KY",
            "license": "1048",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34005676A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "3320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maple Grove Mental Health LLC
• Abigail Marks
• Sydney Martin, RBT
• Robert B Martindale, OD
• Shawna Mathis
• Rebecca Mattingly
• Jacob William Mauck, MA
• Pete Mayfield IV, M.D.
• Tabitha Mayott, LMHC
• Melanie McAlister, OTR/L

• Clinical Social Worker in Clarksville, IN
• Providers in Clarksville, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.