Organization Active NPI

Brian Klaung MSW Inc

  • Social Worker
  • Rockford, IL
National Provider Identifier
1811266919
Registry record updated Dec 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
194-004675 Issued in IL
Legal business name
BRIAN KLAUNG MSW INC
Practice address
6975 Redansa Drive
Rockford, IL 61108-1201
Phone
(815) 398-7000
Fax
(815) 395-0671
NPI assigned
Dec 19, 2011
Last updated
Dec 19, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2011

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

Authorized official

Name
Mr. Brian David Klaung, MSWNPI 1811905102
Title
Clinical Social Worker
Phone
(815) 398-7000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 104100000X 194-004675 IL Primary

Addresses

Primary practice location

6975 Redansa Drive
Rockford, IL 61108-1201

Mailing address

6975 Redansa Drive
Rockford, IL 61108-1201
Phone (815) 398-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120420000666 IL Part B Supplier - Clinic/Group Practice 4385805118 Receives reassigned benefits from 1 practitioner
Practice locations: Rockford, IL

National Provider Directory

National Provider Directory

Locations

6975 Redansa Dr
Rockford, IL 61108
Phone (815) 391-0168

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1324252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324252800000",
    "number": "1811266919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6975 REDANSA DRIVE",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611081201",
            "telephone_number": "815-398-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6975 REDANSA DRIVE",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611081201",
            "telephone_number": "815-398-7000",
            "fax_number": "815-395-0671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIAN KLAUNG MSW INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-19",
        "last_updated": "2011-12-19",
        "status": "A",
        "authorized_official_last_name": "KLAUNG",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "815-398-7000",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": "IL",
            "license": "194-004675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.