Individual provider Active NPI

John Marshall Stubblefield, MSW, LSW

  • Social Worker
  • Indianapolis, IN
National Provider Identifier
1871849281
Registry record updated Aug 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
33006305A Issued in IN
Practice address
2345 S Lynhurst Dr
Indianapolis, IN 46241-8630
Phone
(317) 247-8900
Fax
(317) 247-8935
NPI assigned
Aug 3, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2012

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 33006305A IN Primary

Addresses

Primary practice location

2345 S Lynhurst Dr
Indianapolis, IN 46241-8630

Mailing address

2345 S Lynhurst Dr
Indianapolis, IN 46241-8630
Phone (317) 247-8900

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
I20231009000560 IN Practitioner - Clinical Social Worker 9537514740 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Physicians of Indiana IncGroup PAC ID 1759416662, 1,569 clinicians

Practice addresses (Care Compare)

8102 Clearvista Pkwy
Indianapolis, IN 46256-1661
Phone (317) 849-8222

Hospital & facility affiliations

  • Fairbanks Hospital, Indianapolis, IN, CCN 150179

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33006305AINMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physicians of Indiana Inc CurrentSince Sep 25, 2023 Accepting new patients
Community Health Network, Inc Current Accepting new patients
Community Physicians of Indiana Inc CurrentSince Sep 25, 2023 Accepting new patients
Community Health Network, Inc CurrentSince Sep 25, 2023 Accepting new patients
Cummins Behavioral Health Systems, Incorporated PastSince Apr 13, 2010 Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

8102 Clearvista Pkwy
Indianapolis, IN 46256
Phone (317) 572-9319

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

7165 Clearvista Way
Indianapolis, IN 46256
Phone (317) 621-5100

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

6950 Hillsdale Ct
Indianapolis, IN 46250
Phone (317) 621-7533

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1343952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344816000000",
    "number": "1871849281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2345 S LYNHURST DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462418630",
            "telephone_number": "317-247-8900",
            "fax_number": "317-247-8935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2345 S LYNHURST DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462418630",
            "telephone_number": "317-247-8900",
            "fax_number": "317-247-8935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUBBLEFIELD",
        "first_name": "JOHN",
        "middle_name": "MARSHALL",
        "name_prefix": "Mr.",
        "credential": "MSW, LSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-03",
        "last_updated": "2012-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IN",
            "license": "33006305A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.