Individual provider Active NPI

Brittney Stickdorn

  • Social Worker
  • Chillicothe, OH
National Provider Identifier
1720644685
Registry record updated Jan 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
S.2107111 Issued in OH
Practice address
220 N Plaza Blvd
Chillicothe, OH 45601-1787
Phone
(740) 270-3286
NPI assigned
May 16, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X S.1901124-TRNE OH
Case Manager/Care Coordinator 171M00000X
Social Worker 104100000X S.2107111 OH Primary

Addresses

Primary practice location

220 N Plaza Blvd
Chillicothe, OH 45601-1787

Mailing address

PO Box 55
Walton, KY 41094-0055
Phone (740) 270-3286

Other identifiers 1

IdentifierTypeStateIssuer
0349249MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
S.1901124-TRNEOHMDSocial Worker
S.2107111OHMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Group Home, LLC Past Accepting new patients
Phoenix Group Home, LLC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/pathihc/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": "1557964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643241600000",
    "number": "1720644685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 55",
            "city": "WALTON",
            "state": "KY",
            "postal_code": "410940055",
            "telephone_number": "740-270-3286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 N PLAZA BLVD",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456011787",
            "telephone_number": "740-270-3286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STICKDORN",
        "first_name": "BRITTNEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-16",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.1901124-TRNE",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.2107111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0349249",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chillicothe, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.