Individual provider Active NPI

Sheana J Pryor

  • Clinical Social Worker
  • Louisville, KY
National Provider Identifier
1750561304
Registry record updated Sep 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
255189 Issued in KY
Practice address
2215 Portland Ave
Louisville, KY 40212-1033
Phone
(502) 953-4700
NPI assigned
Nov 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X 255189 KY Primary

Addresses

Primary practice location

2215 Portland Ave
Louisville, KY 40212-1033

Mailing address

PO Box 950244
Louisville, KY 40295-0244
Phone (502) 953-4700

Other identifiers 1

IdentifierTypeStateIssuer
30615058MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20200917001590 KY Practitioner - Clinical Social Worker 6305264623 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hagan Health LLCGroup PAC ID 5890129159, 8 clinicians

Practice addresses (Care Compare)

4010 Dupont Cir
Suite 202
Louisville, KY 40207-4847
Phone (502) 326-3011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
255189KYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Centers, Inc. Current Accepting new patients
Family Health Centers, Inc. Current Accepting new patients
Terry M. Hagan MD Clinical CurrentSince Dec 12, 2022 Accepting new patients
Family Health Centers, Inc. CurrentSince Sep 28, 2020 Accepting new patients
Family Health Centers, Inc. Current Accepting new patients
Family Health Centers, Inc. Current Accepting new patients
Hagan Health LLC Clinical CurrentSince Dec 12, 2022 Accepting new patients
Family Health Centers, Inc. CurrentSince Sep 28, 2020 Accepting new patients

Locations

1000 Neighborhood Pl
Fairdale, KY 40118
Phone (502) 361-2381

712 E Muhammad Ali Blvd
Louisville, KY 40202
Phone (502) 568-6972

4010 DuPont Cir
Ste 202
Louisville, KY 40207
Phone (502) 326-3011

4100 Taylor Blvd
Louisville, KY 40215
Phone (502) 361-2381

834 E Broadway
Louisville, KY 40204
Phone (502) 583-1981

4615 Taylor Blvd
Louisville, KY 40215
Phone (502) 366-4747

2215 Portland Ave
Louisville, KY 40212
Phone (502) 774-8631

Organizations & group practices 8

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": "1194912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599782400000",
    "number": "1750561304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 950244",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402950244",
            "telephone_number": "502-953-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 PORTLAND AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402121033",
            "telephone_number": "502-953-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRYOR",
        "first_name": "SHEANA",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-13",
        "last_updated": "2020-09-11",
        "certification_date": "2020-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "255189",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30615058",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.