Individual provider Active NPI

Amanda Annis, LSW

  • Social Worker
  • Worthington, OH
National Provider Identifier
1760978555
Registry record updated Jun 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
S.2004678 Issued in OH
Practice address
445 E Dublin Granville Rd
Worthington, OH 43085-3192
Phone
(614) 844-3800
NPI assigned
Jul 5, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X S.2004678 OH Primary

Addresses

Primary practice location

445 E Dublin Granville Rd
Worthington, OH 43085-3192

Mailing address

108 Rosebrook CT
Reynoldsburg, OH 43068-4342
Phone (614) 256-1660

Other practice location 1

1649 Brice Rd Ste C
Reynoldsburg, OH 43068-2796
Phone (614) 300-5878

Other practice location 2

5815 Westbourne Ave
Columbus, OH 43213-1459
Phone (833) 510-4357

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.2004678OHMDSocial Worker

Interoperability endpoints

  • Direct secure messaging: amanda.annis.p1@direct.iamboundless.nextgenshare.com

NPI Registry JSON

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

{
    "created_epoch": "1530748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686787200000",
    "number": "1760978555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 ROSEBROOK CT",
            "city": "REYNOLDSBURG",
            "state": "OH",
            "postal_code": "430684342",
            "telephone_number": "614-256-1660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 E DUBLIN GRANVILLE RD",
            "city": "WORTHINGTON",
            "state": "OH",
            "postal_code": "430853192",
            "telephone_number": "614-844-3800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1649 Brice Rd Ste C",
            "address_purpose": "LOCATION",
            "city": "Reynoldsburg",
            "state": "OH",
            "postal_code": "430682796",
            "country_code": "US",
            "telephone_number": "614-300-5878",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5815 Westbourne Ave",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432131459",
            "country_code": "US",
            "telephone_number": "833-510-4357",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANNIS",
        "first_name": "AMANDA",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-05",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.2004678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worthington, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2023; 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.