Individual provider Active NPI

Anita L Misson, MSW

  • Clinical Social Worker
  • Kokomo, IN
National Provider Identifier
1710290374
Registry record updated Aug 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34006928A Issued in IN
Practice address
424 E Southway Blvd
Kokomo, IN 46902
Phone
(765) 288-1928
NPI assigned
Jul 23, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2018

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 34006928A IN Primary

Addresses

Primary practice location

424 E Southway Blvd
Kokomo, IN 46902

Mailing address

240 N Tillotson Ave
Muncie, IN 47304-3988
Phone (765) 288-1928

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20141006001224 IN Practitioner - Clinical Social Worker 8123248648 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34006928AINMDClinical Social Worker

Interoperability endpoints

  • Direct secure messaging: anita.misson.p1@direct.meridianhs.nextgenshare.com

Organizations & group practices 1

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": "1279843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535414400000",
    "number": "1710290374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 N TILLOTSON AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473043988",
            "telephone_number": "765-288-1928",
            "fax_number": "765-741-0335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 E SOUTHWAY BLVD",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "46902",
            "telephone_number": "765-288-1928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISSON",
        "first_name": "ANITA",
        "middle_name": "L",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-23",
        "last_updated": "2018-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34006928A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kokomo, IN

Sources for this page

Verify at the official NPI Registry.