Individual provider Active NPI

Tianna Niesen, LCSW

  • Clinical Social Worker
  • West Plains, MO
National Provider Identifier
1861053332
Registry record updated Nov 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2021034969 Issued in MO
Practice address
1211 Porter Wagoner Blvd # 23
West Plains, MO 65775-1826
Phone
(417) 257-6762
NPI assigned
Jun 25, 2019
Last updated
Nov 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2023

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 2021034969 MO Primary

Addresses

Primary practice location

1211 Porter Wagoner Blvd # 23
West Plains, MO 65775-1826

Mailing address

PO Box 1100
West Plains, MO 65775-1100

Other practice location 1

2900 Independence Sq
West Plains, MO 65775-4238
Phone (417) 620-3396

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20220111001862 MO Practitioner - Clinical Social Worker 8224420831 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
Group practices
Ozarks Medical CenterGroup PAC ID 3870491863, 166 clinicians

Practice addresses (Care Compare)

1211 Porter Wagoner Blvd
Suite 23
West Plains, MO 65775-1826
Phone 41725767623010

Merit-based Incentive Payment System (MIPS)

Final score
88.96 of 100Reported as group
Quality
78.58
Promoting interoperability
99
Improvement activities
40
Cost
77.82

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ozarks Medical Center CurrentSince Oct 12, 2021 Accepting new patients
Ozarks Medical Center CurrentSince Oct 12, 2021 Accepting new patients
Rural Alliance for Better Family Health PastSince Jun 4, 2024 Accepting new patients

Locations

1100 N Kentucky Ave
West Plains, MO 65775
Phone (417) 257-5959

1137 Independence Dr
West Plains, MO 65775
Phone (417) 255-8464

1211 Porter Wagoner Blvd
#23
West Plains, MO 65775
Phone 4172576762 ext. 4140

1211 Porter Wagoner Blvd
#23P
West Plains, MO 65775

1211 Porter Wagoner Blvd
Ste 23
West Plains, MO 65775
Phone (417) 257-6762

2900 Independence Sq
West Plains, MO 65775
Phone (417) 255-2727

Organizations & group practices 3

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": "1561420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698796800000",
    "number": "1861053332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1100",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "657751100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 PORTER WAGONER BLVD # 23",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "657751826",
            "telephone_number": "417-257-6762"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2900 Independence Sq",
            "address_purpose": "LOCATION",
            "city": "West Plains",
            "state": "MO",
            "postal_code": "657754238",
            "country_code": "US",
            "telephone_number": "417-620-3396",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIESEN",
        "first_name": "TIANNA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-25",
        "last_updated": "2023-11-01",
        "certification_date": "2023-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2021034969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Plains, MO

Sources for this page

Verify at the official NPI Registry.