Individual provider Active NPI

Joni C Spohn, LCSW

  • Clinical Social Worker
  • St Charles, IL
National Provider Identifier
1821079732
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
475 Dunham Rd
Suite F
St Charles, IL 60174-1498
Phone
(630) 444-0004
Fax
(630) 444-0004
NPI assigned
Nov 8, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 IL Primary

Addresses

Primary practice location

475 Dunham Rd
Suite F
St Charles, IL 60174-1498

Mailing address

475 Dunham Rd
Suite F
St Charles, IL 60174-1498
Phone (630) 444-0004

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20041221000328 IL Practitioner - Clinical Social Worker 6507824687 Practice locations: St Charles, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

475 Dunham Rd
St Charles, IL 60174-1498
Phone (630) 444-0004

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149-004319ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Shine Medical Providers PC 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821079732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 DUNHAM RD",
            "address_2": "SUITE F",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601741498",
            "telephone_number": "630-444-0004",
            "fax_number": "630-444-0004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 DUNHAM RD",
            "address_2": "SUITE F",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601741498",
            "telephone_number": "630-444-0004",
            "fax_number": "630-444-0004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPOHN",
        "first_name": "JONI",
        "middle_name": "C",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Charles, IL

Sources for this page

Verify at the official NPI Registry.