Individual provider Active NPI

Nicole Uhlmann, LCSW

  • Clinical Social Worker
  • Bloomington, IL
National Provider Identifier
1922417740
Registry record updated Feb 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34007430A Issued in IN
Practice address
808 S Eldorado Rd
Ste 102
Bloomington, IL 61704-6071
Phone
(309) 706-3190
Fax
(309) 588-4115
NPI assigned
Aug 6, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 34007430A IN Primary
Clinical Social Worker 1041C0700X 149018036 IL

Addresses

Primary practice location

808 S Eldorado Rd
Ste 102
Bloomington, IL 61704-6071

Mailing address

213 NW 10TH St
Ste a
Fairfield, IL 62837-1219
Phone (618) 842-4617

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20160411001212 IL Practitioner - Clinical Social Worker 9830491448 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of ClayGroup PAC ID 0042101982, 77 clinicians

Practice addresses (Care Compare)

911 Stacey Burk Dr
Flora, IL 62839-3241
Phone (618) 662-2131

929 Stacey Burk Dr
Flora, IL 62839-3241
Phone (618) 662-2131

939 Sunset Rd SW
Clay City, IL 62824-1113
Phone (618) 662-2191

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149018036ILMDClinical Social Worker
34007430AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
County of Clay CurrentSince May 18, 2023 Accepting new patients
County of Clay Current Accepting new patients
County of Clay CurrentSince May 18, 2023 Accepting new patients
County of Clay Past Accepting new patients

Locations

939 Sunset Rd SW
Clay City, IL 62824
Phone (686) 662-2131

911 Stacey Burk Dr
Flora, IL 62839
Phone (618) 662-2161

929 Stacey Burk Dr
Flora, IL 62839

14265 Highway 45
Louisville, IL 62858

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1407283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517443200000",
    "number": "1922417740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 NW 10TH ST",
            "address_2": "STE A",
            "city": "FAIRFIELD",
            "state": "IL",
            "postal_code": "628371219",
            "telephone_number": "618-842-4617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 S ELDORADO RD",
            "address_2": "STE 102",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617046071",
            "telephone_number": "309-706-3190",
            "fax_number": "309-588-4115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UHLMANN",
        "first_name": "NICOLE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-06",
        "last_updated": "2018-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34007430A",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149018036",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IL

Sources for this page

Verify at the official NPI Registry.