Individual provider Active NPI

Brittney Leigh Bimler, LICSW

  • Clinical Social Worker
  • Thief River Falls, MN
National Provider Identifier
1760971196
Registry record updated Feb 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
23831 Issued in MN
Practice address
120 Labree Ave S
Thief River Falls, MN 56701-2819
Phone
(218) 683-4338
Fax
(218) 683-4551
NPI assigned
May 1, 2018
Last updated
Feb 5, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2020

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 23831 MN Primary

Addresses

Primary practice location

120 Labree Ave S
Thief River Falls, MN 56701-2819

Mailing address

120 Labree Ave S
Thief River Falls, MN 56701-2819
Phone (218) 683-4338

Other names 1

  • Brittney Leigh Odberg Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20180926001811 MN Practitioner - Clinical Social Worker 0345591665 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of North Dakota School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford Health Network NorthGroup PAC ID 8022206663, 114 clinicians

Practice addresses (Care Compare)

120 Labree Ave S
Thief River Falls, MN 56701-2819
Phone (218) 683-4349

1720 Hwy 59 S
Thief River Falls, MN 56701-4331
Phone (218) 681-4747

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
23831MNMDClinical Social Worker

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, 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": "1525132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580860800000",
    "number": "1760971196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 LABREE AVE S",
            "city": "THIEF RIVER FALLS",
            "state": "MN",
            "postal_code": "567012819",
            "telephone_number": "218-683-4338",
            "fax_number": "218-683-4551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 LABREE AVE S",
            "city": "THIEF RIVER FALLS",
            "state": "MN",
            "postal_code": "567012819",
            "telephone_number": "218-683-4338",
            "fax_number": "218-683-4551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIMLER",
        "first_name": "BRITTNEY",
        "middle_name": "LEIGH",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-01",
        "last_updated": "2020-02-05",
        "certification_date": "2020-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "23831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRITTNEY",
            "last_name": "ODBERG",
            "middle_name": "LEIGH",
            "credential": "LICSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Thief River Falls, MN

Sources for this page

Verify at the official NPI Registry.