Individual provider Active NPI

Carrie Maddox

  • Social Worker
  • Tawas City, MI
National Provider Identifier
1801374061
Registry record updated Jul 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
1199 Harris Ave
Tawas City, MI 48763-9681
Phone
(989) 362-8636
NPI assigned
Jul 31, 2018
Last updated
Jul 31, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2018

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 Primary

Addresses

Primary practice location

1199 Harris Ave
Tawas City, MI 48763-9681

Mailing address

1199 Harris Ave
Tawas City, MI 48763-9681

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20220517001005 MI Practitioner - Clinical Social Worker 4183001969 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

720 W Wackerly St
Suite 11
Midland, MI 48640-2769
Phone (989) 832-2165

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Partners in Change: Psychological & Community Services, PLC CurrentSince Jun 1, 2022 Accepting new patients

Locations

720 W Wackerly St
Ste 11
Midland, MI 48640
Phone (989) 832-2165

211 S Crapo St
Ste M
Mt Pleasant, MI 48858
Phone (989) 463-1101

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": "1532995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532995200000",
    "number": "1801374061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1199 HARRIS AVE",
            "city": "TAWAS CITY",
            "state": "MI",
            "postal_code": "487639681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1199 HARRIS AVE",
            "city": "TAWAS CITY",
            "state": "MI",
            "postal_code": "487639681",
            "telephone_number": "989-362-8636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADDOX",
        "first_name": "CARRIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-31",
        "last_updated": "2018-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tawas City, MI

Sources for this page

Verify at the official NPI Registry.