Active NPI
Joanne K Scanlon, MSW
- Social Worker
- Boulder, CO
National Provider Identifier
1699779306
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 991313
- Practice address
- 3482 Broadway St
Boulder, CO 80304-1824 - Phone
- (303) 413-7500
- Fax
- (303) 441-1452
- NPI assigned
- Jun 9, 2005
- 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 | 991313 | CO | Primary |
Addresses
Primary practice location
3482 Broadway St
Boulder, CO 80304-1824
Mailing address
3450 Broadway St
Boulder, CO 80304-1824
Phone (303) 441-1175
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 60481846 | Medicaid | CO |
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 |
|---|---|---|---|
| 991313 | CO | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118275200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1699779306",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3450 BROADWAY ST",
"city": "BOULDER",
"state": "CO",
"postal_code": "803041824",
"telephone_number": "303-441-1175",
"fax_number": "303-441-1452"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3482 BROADWAY ST",
"city": "BOULDER",
"state": "CO",
"postal_code": "803041824",
"telephone_number": "303-413-7500",
"fax_number": "303-441-1452"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCANLON",
"first_name": "JOANNE",
"middle_name": "K",
"credential": "MSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-06-09",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CO",
"license": "991313",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "60481846",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Boulder, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.