Individual provider Active NPI

Roberta S Higginbotham, LCSW

  • Clinical Social Worker
  • Brandon, FL
National Provider Identifier
1700428034
Registry record updated Oct 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW11273 Issued in FL
Practice address
421 Lithia Pinecrest Rd
Brandon, FL 33511-6138
Phone
(813) 315-8648
NPI assigned
Oct 8, 2019
Last updated
Oct 8, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2019

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 SW11273 FL Primary

Addresses

Primary practice location

421 Lithia Pinecrest Rd
Brandon, FL 33511-6138

Mailing address

PO Box 4643
Plant City, FL 33563-0029
Phone (813) 763-1783

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20200123000854 FL Practitioner - Clinical Social Worker 6305271297 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Brandon Mental HealthGroup PAC ID 8527136977, 15 clinicians

Practice addresses (Care Compare)

1134 Bell Shoals Rd
Brandon, FL 33511-8813
Phone (813) 315-8648

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW11273FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Brandon Mental Health CurrentSince Oct 14, 2019 Accepting new patients
Auto Injury EMS's of Florida PastSince Oct 13, 2019 Accepting new patients

Locations

1134 Bell Shoals Rd
Brandon, FL 33511
Phone (813) 315-8648

421 Lithia Pinecrest Rd
Brandon, FL 33511
Phone (813) 312-3036

Networks

  • Freedom Health HMO Network

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1570492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570492800000",
    "number": "1700428034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4643",
            "city": "PLANT CITY",
            "state": "FL",
            "postal_code": "335630029",
            "telephone_number": "813-763-1783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 LITHIA PINECREST RD",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335116138",
            "telephone_number": "813-315-8648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIGGINBOTHAM",
        "first_name": "ROBERTA",
        "middle_name": "S",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-08",
        "last_updated": "2019-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW11273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

Verify at the official NPI Registry.