Individual provider Active NPI

Roxanne D Brunsman, MSW,LCSW

  • Clinical Social Worker
  • Indianapolis, IN
National Provider Identifier
1740212505
Registry record updated May 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34003970A Issued in IN
Practice address
9135 North Meridian St
Suite a-9
Indianapolis, IN 46260
Phone
(765) 620-4628
Fax
(765) 683-9583
NPI assigned
Jul 6, 2006
Last updated
May 7, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2009

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 34003970A IN Primary

Addresses

Primary practice location

9135 North Meridian St
Suite a-9
Indianapolis, IN 46260

Mailing address

6173 North 100 West
Alexandria, IN 46001
Phone (765) 620-4628

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
I20081106000885 IN Practitioner - Clinical Social Worker 6204995111 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

Alexandria, IN 46001
Phone (765) 683-9583

6173 N 100
Alexandria, IN 46001-8219

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34003970AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Roxanne Brunsman LCSW LLC Clinical CurrentSince Oct 1, 2011 Accepting new patients
University Obstetricians-Gynecologists,Inc Clinical PastSince Nov 15, 1996 Accepting new patients

Locations

405 W 8th St
Ste 2
Anderson, IN 46016
Phone (765) 620-4628

6524 Carrollton Ave
Indianapolis, IN 46220
Phone (317) 225-0380

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": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241654400000",
    "number": "1740212505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6173 NORTH 100 WEST",
            "city": "ALEXANDRIA",
            "state": "IN",
            "postal_code": "46001",
            "telephone_number": "765-620-4628",
            "fax_number": "765-683-9583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9135 NORTH MERIDIAN ST",
            "address_2": "SUITE A-9",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46260",
            "telephone_number": "765-620-4628",
            "fax_number": "765-683-9583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNSMAN",
        "first_name": "ROXANNE",
        "middle_name": "D",
        "credential": "MSW,LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2009-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34003970A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.