Individual provider Active NPI

Nikie Iwanczuk

  • Social Worker
  • Fall River, MA
National Provider Identifier
1679055768
Registry record updated Sep 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
119445 Issued in MA
Practice address
991 Jefferson St
Fall River, MA 02721-4834
Phone
(774) 930-6344
NPI assigned
Sep 5, 2018
Last updated
Sep 5, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 119445 MA Primary

Addresses

Primary practice location

991 Jefferson St
Fall River, MA 02721-4834

Mailing address

232 Arnold St
New Bedford, MA 02740-3536
Phone (774) 930-6344

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

LicenseStateTypeSpecialty
119445MAMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1536105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536105600000",
    "number": "1679055768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "232 ARNOLD ST",
            "city": "NEW BEDFORD",
            "state": "MA",
            "postal_code": "027403536",
            "telephone_number": "774-930-6344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "991 JEFFERSON ST",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027214834",
            "telephone_number": "774-930-6344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IWANCZUK",
        "first_name": "NIKIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-05",
        "last_updated": "2018-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MA",
            "license": "119445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fall River, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.