Individual provider Active NPI

Dustin Fodo, LMSW

  • Social Worker
  • Bay City, MI
National Provider Identifier
1821773375
Registry record updated Mar 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801121139 Issued in MI
Practice address
690 S Trumbull St
Bay City, MI 48708-7692
Phone
(989) 922-5700
Fax
(989) 771-7050
NPI assigned
Jun 21, 2023
Last updated
Mar 24, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2026

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 6801121139 MI Primary

Addresses

Primary practice location

690 S Trumbull St
Bay City, MI 48708-7692

Mailing address

501 Lapeer Ave
Saginaw, MI 48607-1203
Phone (989) 759-6464

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
I20230625000027 MI Practitioner - Clinical Social Worker 0941668891 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801121139MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Great Lakes Bay Health Centers CurrentSince Jun 19, 2023 Accepting new patients
Great Lakes Bay Health Centers CurrentSince Jun 19, 2023 Accepting new patients

Locations

690 S Trumbull St
Bay City, MI 48708
Phone (989) 922-4900

501 Lapeer Ave
Saginaw, MI 48607
Phone (989) 753-6000

501 Lapeer Ave
#R
Saginaw, MI 48607
Phone (989) 753-6000

Organizations & group practices 2

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": "1687305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774310400000",
    "number": "1821773375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 LAPEER AVE",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486071203",
            "telephone_number": "989-759-6464",
            "fax_number": "989-399-8233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 S TRUMBULL ST",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "487087692",
            "telephone_number": "989-922-5700",
            "fax_number": "989-771-7050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FODO",
        "first_name": "DUSTIN",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-21",
        "last_updated": "2026-03-24",
        "certification_date": "2026-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801121139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay City, MI

Sources for this page

Verify at the official NPI Registry.