Isabella G Gormanson, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

13649 Issued in SC

Practice address

3809 Rosewood Dr
Columbia, SC 29205-3533

Phone

(803) 939-2642

NPI assigned

Aug 10, 2020

Last updated

Aug 10, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/7878c7ba-d1a3-4bd2-9b45-7234d7142c12/

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.

• Mental Illness Recovery Center

  • Community/Behavioral Health Agency
  • Columbia, SC
  • NPI 1194047563
  Medicare reassignment NPD

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

{
    "created_epoch": "1597017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597017600000",
    "number": "1679184154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3809 ROSEWOOD DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292053533",
            "telephone_number": "803-939-2642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3809 ROSEWOOD DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292053533",
            "telephone_number": "803-939-2642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORMANSON",
        "first_name": "ISABELLA",
        "middle_name": "G",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-10",
        "last_updated": "2020-08-10",
        "certification_date": "2020-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "SC",
            "license": "13649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lloyd Malcom Gordon, DDS
• Lucille Coursen Gordon, MSW LISW CP
• Rachel Marie Gordon
• Shaniya Gordon
• Melissa B Gore, LISW-CP
• Eric Gormley
• Shayla Gortman
• Kelly Day Gothard, M.S.
• Cynthia Marie Gotheridge
• Venkateshwar K Gottipaty, MD, PHD

• Social Worker in Columbia, SC
• Providers in Columbia, SC by specialty
• Social Worker in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2020; 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.