Individual provider Active NPI

Rachel Ford, MSW,LCSW

  • Clinical Social Worker
  • Mishawaka, IN
National Provider Identifier
1871060459
Registry record updated Mar 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34008296A Issued in IN
Practice address
1818 Went Ave Ste a
Mishawaka, IN 46545
Phone
(574) 254-0229
Fax
(574) 254-0188
NPI assigned
Oct 31, 2018
Last updated
Mar 13, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2019

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 34008296A IN Primary

Addresses

Primary practice location

1818 Went Ave Ste a
Mishawaka, IN 46545

Mailing address

240 N Tillotson Ave
Muncie, IN 47304-3988
Phone (765) 288-1928

Other practice location 1

3201 E Center Street Ext
Warsaw, IN 46582-3907
Phone (574) 267-1700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20190107001173 IN Practitioner - Clinical Social Worker 5193061521 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Meridian Health Services CorpGroup PAC ID 5597679845, 78 clinicians

Practice addresses (Care Compare)

1818 Went Ave
Suite a
Mishawaka, IN 46545-6482
Phone (765) 288-1928

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34008296AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Meridian Health Services Corp. CurrentSince Feb 18, 2019 Accepting new patients
Meridian Health Services Corp CurrentSince Feb 18, 2019 Accepting new patients
McArthur Mental Health Services PastSince Dec 28, 2018 Accepting new patients

Locations

1818 Went Ave
Ste A
Mishawaka, IN 46545
Phone (574) 254-0229

240 N Tillotson Ave
Muncie, IN 47304

Interoperability endpoints

  • Direct secure messaging: rachel.ford.p1@direct.meridianhs.nextgenshare.com

Organizations & group practices 4

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": "1540944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552435200000",
    "number": "1871060459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 N TILLOTSON AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473043988",
            "telephone_number": "765-288-1928",
            "fax_number": "765-741-0335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 WENT AVE STE A",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "46545",
            "telephone_number": "574-254-0229",
            "fax_number": "574-254-0188"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3201 E Center Street Ext",
            "address_purpose": "LOCATION",
            "city": "Warsaw",
            "state": "IN",
            "postal_code": "465823907",
            "country_code": "US",
            "telephone_number": "574-267-1700",
            "fax_number": "574-267-0017",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORD",
        "first_name": "RACHEL",
        "credential": "MSW,LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-31",
        "last_updated": "2019-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34008296A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mishawaka, IN

Sources for this page

Verify at the official NPI Registry.