Active NPI
Jordan Wadsworth
- Clinical Social Worker
- Bloomington, IN
National Provider Identifier
1811680721
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 822 W 1St St Ste 8
Bloomington, IN 47403-2382 - Phone
- (812) 822-1395
- NPI assigned
- May 29, 2023
- Last updated
- May 29, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | NU | Primary |
Addresses
Primary practice location
822 W 1St St Ste 8
Bloomington, IN 47403-2382
Mailing address
800 N Smith Rd Apt 2Y
Bloomington, IN 47408-2965
Phone (317) 590-2473
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bedford Transitions, LLC | Past | Accepting new patients |
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.
-
- General Practice Physician
- Bedford, IN
- NPI 1790297216
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1685318400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685318400000",
"number": "1811680721",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 N SMITH RD APT 2Y",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474082965",
"telephone_number": "317-590-2473"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "822 W 1ST ST STE 8",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474032382",
"telephone_number": "812-822-1395"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WADSWORTH",
"first_name": "JORDAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-05-29",
"last_updated": "2023-05-29",
"certification_date": "2023-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 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.