Individual provider Active NPI

John B Ridgeway, LLP LMSW CAAC SAP

  • Clinical Social Worker
  • Flint, MI
National Provider Identifier
1881624146
Registry record updated Jul 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801013086 Issued in MI
Practice address
G 4511 Miller Rd
Flint, MI 48507-1107
Phone
(810) 720-0640
Fax
(810) 720-0640
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CAC-I,SAP MI
Clinical Psychologist 103TC0700X 6301003780 MI
Clinical Social Worker 1041C0700X 6801013086 MI Primary

Addresses

Primary practice location

G 4511 Miller Rd
Flint, MI 48507-1107

Mailing address

G 4511 Miller Rd
Flint, MI 48507-1107
Phone (810) 720-0640

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
I20041210000408 MI Practitioner - Clinical Social Worker 1658338710 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2387 S Linden Rd
Suite 122
Flint, MI 48532-5487
Phone (810) 720-0640

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CAC-I,SAPMIMDAddiction (Substance Use Disorder) Counselor
6301003780MIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
John B Ridgeway,LLC Addiction (Substance Use Disorder) CurrentSince Mar 15, 2005 Accepting new patients

Locations

2425 S Linden Rd
Ste D105
Flint, MI 48532
Phone (810) 252-7994

2387 S Linden Rd
Ste 122
Flint, MI 48532
Phone (810) 720-0640

4511 Miller Rd
Flint, MI 48507
Phone (810) 230-2640

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": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373414400000",
    "number": "1881624146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "G 4511 MILLER RD",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485071107",
            "telephone_number": "810-720-0640",
            "fax_number": "810-720-0640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "G 4511 MILLER RD",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485071107",
            "telephone_number": "810-720-0640",
            "fax_number": "810-720-0640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDGEWAY",
        "first_name": "JOHN",
        "middle_name": "B",
        "name_prefix": "Mr.",
        "credential": "LLP LMSW CAAC SAP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2013-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "CAC-I,SAP",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301003780",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801013086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

Verify at the official NPI Registry.