Individual provider Active NPI

Sharon J Mellor, LCSW

  • Clinical Social Worker
  • Redlands, CA
National Provider Identifier
1932319241
Registry record updated Nov 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS22891 Issued in CA
Practice address
51 W Olive Ave
Redlands, CA 92373-5243
Phone
(909) 793-1078
NPI assigned
May 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2007

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 LCS22891 CA Primary

Addresses

Primary practice location

51 W Olive Ave
Redlands, CA 92373-5243

Mailing address

11558 Whittier Ave
Loma Linda, CA 92354-4124
Phone (909) 793-1078

Other identifiers 1

IdentifierTypeStateIssuer
LCS22891OtherCALISCENSE NO.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20090807000610 CA Practitioner - Clinical Social Worker 1153402797 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1686 Barton Rd
Redlands, CA 92373-1488
Phone (909) 558-9551

Merit-based Incentive Payment System (MIPS)

Final score
88.87 of 100Reported as group
Quality
72.13
Promoting interoperability
80
Improvement activities
40
Cost
77.36

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS22891CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Aug 15, 2006 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Aug 15, 2006 Accepting new patients

Locations

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

1686 Barton Rd
Redlands, CA 92373
Phone (909) 558-9200

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196294400000",
    "number": "1932319241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11558 WHITTIER AVE",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923544124",
            "telephone_number": "909-793-1078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 W OLIVE AVE",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923735243",
            "telephone_number": "909-793-1078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELLOR",
        "first_name": "SHARON",
        "middle_name": "J",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2007-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS22891",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LISCENSE NO.",
            "identifier": "LCS22891",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redlands, CA

Sources for this page

Verify at the official NPI Registry.