Individual provider Active NPI

Roberta Lynn Williams, LCSW

  • School Social Worker
  • Indianapolis, IN
National Provider Identifier
1669508941
Registry record updated Dec 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Social WorkerTaxonomy code 1041S0200X
License
34002499A Issued in IN
Practice address
1500 N Ritter Ave
Indianapolis, IN 46219-3027
Phone
(317) 355-2560
NPI assigned
Feb 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Social Worker 1041S0200X 34002499A IN Primary

Addresses

Primary practice location

1500 N Ritter Ave
Indianapolis, IN 46219-3027

Mailing address

6626 E 75TH Street
Ste 500
Indianapolis, IN 46250-2890
Phone (317) 621-7561

Other identifiers 1

IdentifierTypeStateIssuer
100270530AMedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address RWILLIAMS9422@ECOMMUNITYDIRECT.COM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20141121001098 IN Practitioner - Clinical Social Worker 4486899945 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health Network IncGroup PAC ID 1850203977, 95 clinicians

Practice addresses (Care Compare)

6950 Hillsdale CT
Indianapolis, IN 46250-2040
Phone (317) 621-7740

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Network, Inc CurrentSince Nov 1, 2014 Accepting new patients
Community Health Network, Inc Current Accepting new patients
Community Health Network, Inc Past Accepting new patients
Community Health Network, Inc. Past Accepting new patients

Locations

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

6950 Hillsdale Ct
Indianapolis, IN 46250
Phone (317) 621-7533

1500 N Ritter Ave
Indianapolis, IN 46219
Phone (317) 355-5041

Interoperability endpoints

  • Direct secure messaging: rwilliams9422@ecommunitydirect.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1669508941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH STREET",
            "address_2": "STE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890",
            "telephone_number": "317-621-7561",
            "fax_number": "317-355-6096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 N RITTER AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462193027",
            "telephone_number": "317-355-2560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "ROBERTA",
        "middle_name": "LYNN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-23",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "IN",
            "license": "34002499A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100270530A",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "RWILLIAMS9422@ECOMMUNITYDIRECT.COM",
            "affiliation": "N",
            "address_1": "1500 N Ritter Ave",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462193027",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.