Individual provider Active NPI

Bilreka Ferguson, LISW-S

  • Clinical Social Worker
  • Ironton, OH
National Provider Identifier
1669833224
Registry record updated Apr 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.0800163-SUPV Issued in OH
Practice address
700 Park Ave
Ironton, OH 45638-1502
Phone
(740) 532-1613
Fax
(740) 532-1715
NPI assigned
Mar 10, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I.0800163-SUPV OH Primary

Addresses

Primary practice location

700 Park Ave
Ironton, OH 45638-1502

Mailing address

PO Box 108
Ironton, OH 45638-0108
Phone (740) 532-1613

Other identifiers 1

IdentifierTypeStateIssuer
0167165MedicaidOH

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
I20190510000861 OH Practitioner - Clinical Social Worker 7113195355 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.0800163-SUPVOHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mended Reeds Services, Inc. Clinical CurrentSince Mar 12, 2019 Accepting new patients

Locations

700 Park Ave
Ironton, OH 45638
Phone (740) 532-1613

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1457568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524700800000",
    "number": "1669833224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 108",
            "city": "IRONTON",
            "state": "OH",
            "postal_code": "456380108",
            "telephone_number": "740-532-1613",
            "fax_number": "740-532-1715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 PARK AVE",
            "city": "IRONTON",
            "state": "OH",
            "postal_code": "456381502",
            "telephone_number": "740-532-1613",
            "fax_number": "740-532-1715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERGUSON",
        "first_name": "BILREKA",
        "credential": "LISW-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-10",
        "last_updated": "2018-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.0800163-SUPV",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0167165",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ironton, OH

Sources for this page

Verify at the official NPI Registry.