Active NPI
Angel Luis
- Social Worker
- Columbus, OH
National Provider Identifier
1669048906
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- S.2106120
- Practice address
- 500 E Main St
Columbus, OH 43215-5369 - Phone
- (614) 355-6342
- NPI assigned
- May 27, 2021
- 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 | S.2106120 | OH | Primary |
Addresses
Primary practice location
500 E Main St
Columbus, OH 43215-5369
Mailing address
Dept 781625
Detroit, MI 48278-1625
Phone (614) 355-8004
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1473276 | Medicaid | OH |
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 |
|---|---|---|---|
| S.2106120 | OH | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1622073600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624924800000",
"number": "1669048906",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "DEPT 781625",
"city": "DETROIT",
"state": "MI",
"postal_code": "482781625",
"telephone_number": "614-355-8004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 E MAIN ST",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432155369",
"telephone_number": "614-355-6342"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUIS",
"first_name": "ANGEL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-05-27",
"last_updated": "2021-06-29",
"certification_date": "2021-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OH",
"license": "S.2106120",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1473276",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.