Samantha Marie Grooms, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34006419A Issued in IN

Practice address

450 Saint John Rd Ste 501
Michigan City, IN 46360-7349

Phone

(219) 879-0676

Fax

(219) 873-9868

NPI assigned

Jul 6, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Clinical Social Worker

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Laporte County Comprehensive Mental Health CouncilGroup PAC ID 3274703046, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Laporte County Comprehensive Mental Health Council

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Michigan City, IN
  • NPI 1295746816

  IN

  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1246838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326931200000",
    "number": "1760611354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 SAINT JOHN RD STE 501",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463607349",
            "telephone_number": "219-879-0676",
            "fax_number": "219-873-9868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 SAINT JOHN RD STE 501",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463607349",
            "telephone_number": "219-879-0676",
            "fax_number": "219-873-9868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROOMS",
        "first_name": "SAMANTHA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-06",
        "last_updated": "2012-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34006419A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100163580",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tiffany Green, MSW
• Donald Ernest Greer Jr.
• Kristine Griffis, RN
• Carol Joan Grobner, DO
• Cynthia Grace Gronemeyer, LCSW
• Courtney Lynn Grounds
• Zhijun Guo, MD
• Rakesh Kumar Gupta, MD
• Eileen Haas, PTA
• Rita Anne Halac, FNP

• All providers in Michigan City, IN
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.