Andrea Kristin Smothers, MSW LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

10122 Issued in MN

Practice address

77 West 5TH Street
Zumbrota, MN 55992

Phone

(507) 732-4136

Fax

(507) 732-4411

NPI assigned

Jun 27, 2006

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

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in MN

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

Specialty

Clinical Social Worker

Education

Other, 1992

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Covered Bridge Family Resources LLC

  • Clinical Social Worker
  • Zumbrota, MN
  • NPI 1245258722
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700813623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 134",
            "city": "ZUMBROTA",
            "state": "MN",
            "postal_code": "55992",
            "telephone_number": "507-732-4136",
            "fax_number": "507-732-4411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 WEST 5TH STREET",
            "city": "ZUMBROTA",
            "state": "MN",
            "postal_code": "55992",
            "telephone_number": "507-732-4136",
            "fax_number": "507-732-4411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMOTHERS",
        "first_name": "ANDREA",
        "middle_name": "KRISTIN",
        "name_prefix": "Mrs.",
        "credential": "MSW LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "10122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREF ONE",
            "identifier": "1034004",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MMSI",
            "identifier": "125740",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "U CARE",
            "identifier": "127608",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "694S5SM",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "6231853",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEAK",
            "identifier": "990991034004",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Zumbrota, MN
• Providers in Zumbrota, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.