Individual provider Active NPI

Clayton Fraunfelter, LISW

  • Clinical Social Worker
  • Athens, OH
National Provider Identifier
1700384153
Registry record updated Oct 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.1800790 Issued in OH
Practice address
11 Graham Dr
Athens, OH 45701-1430
Phone
(740) 594-6807
Fax
(740) 594-9967
NPI assigned
Jan 30, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2021

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.1800790 OH Primary

Addresses

Primary practice location

11 Graham Dr
Athens, OH 45701-1430

Mailing address

PO Box 132
Athens, OH 45701-0132
Phone (740) 594-6807

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
I20180321001988 OH Practitioner - Clinical Social Worker 8224390737 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Services for Behavioral HealthGroup PAC ID 9234372525, 39 clinicians

Practice addresses (Care Compare)

11 Graham Dr
Athens, OH 45701-1430
Phone (740) 594-6807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.1800790OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Services for Behavioral Health Clinical CurrentSince Feb 13, 2018 Accepting new patients
Integrated Services for Behavioral Health PastSince Feb 13, 2018 Accepting new patients

Locations

11 Graham Dr
Athens, OH 45701
Phone (740) 594-6807

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/isaoh/r4/

Organizations & group practices 2

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": "1517270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633996800000",
    "number": "1700384153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 132",
            "city": "ATHENS",
            "state": "OH",
            "postal_code": "457010132",
            "telephone_number": "740-594-6807",
            "fax_number": "740-594-9967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 GRAHAM DR",
            "city": "ATHENS",
            "state": "OH",
            "postal_code": "457011430",
            "telephone_number": "740-594-6807",
            "fax_number": "740-594-9967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAUNFELTER",
        "first_name": "CLAYTON",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-30",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1800790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, OH

Sources for this page

Verify at the official NPI Registry.