Individual provider Active NPI

John E. Yeomans, LCSW

  • Clinical Social Worker
  • Providence, RI
National Provider Identifier
1720164106
Registry record updated Oct 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ISW02936 Issued in RI
Practice address
40 Candace St
Providence, RI 02908-3747
Phone
(401) 444-0550
Fax
(401) 444-0425
NPI assigned
Oct 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LC7767 ME
Clinical Social Worker 1041C0700X ISW02936 RI Primary

Addresses

Primary practice location

40 Candace St
Providence, RI 02908-3747

Mailing address

375 Allens Ave
Providence, RI 02905-5010
Phone (401) 444-0400

Other practice location 1

100 Campus Ave Ste A&b
Lewiston, ME 04240-6040
Phone (207) 755-3434

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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
I20120203000250 ME Practitioner - Clinical Social Worker 5294992145 Reassigns benefits to 1 organization
Practice locations: Lewiston, ME

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sweetser CurrentSince Jul 5, 2020 Accepting new patients

Locations

329 Bath Rd
Brunswick, ME 04011
Phone (207) 373-3012

571 Sabattus St
Ste 11
Lewiston, ME 04240
Phone (207) 786-3388

50 Moody St
Saco, ME 04072
Phone (207) 284-5981

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": "1161993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570147200000",
    "number": "1720164106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 ALLENS AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029055010",
            "telephone_number": "401-444-0400",
            "fax_number": "401-444-0468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 CANDACE ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029083747",
            "telephone_number": "401-444-0550",
            "fax_number": "401-444-0425"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Campus Ave Ste A&b",
            "address_purpose": "LOCATION",
            "city": "Lewiston",
            "state": "ME",
            "postal_code": "042406040",
            "country_code": "US",
            "telephone_number": "207-755-3434",
            "fax_number": "207-755-3474",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YEOMANS",
        "first_name": "JOHN",
        "middle_name": "E.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-28",
        "last_updated": "2019-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC7767",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "ISW02936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.