Individual provider Active NPI

Cory J Vedin, LMSW

  • Clinical Social Worker
  • Iron Mountain, MI
National Provider Identifier
1952410847
Registry record updated Jun 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801086739 Issued in MI
Practice address
333 S Stephenson Ave
Iron Mountain, MI 49801-2942
Phone
(906) 235-2261
NPI assigned
Aug 30, 2006
Last updated
Jun 26, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2020

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 6801086739
Clinical Social Worker 1041C0700X 6801086739 MI Primary

Addresses

Primary practice location

333 S Stephenson Ave
Iron Mountain, MI 49801-2942

Mailing address

PO Box 842
Iron Mountain, MI 49801-0842
Phone (906) 828-5118

Other identifiers 1

IdentifierTypeStateIssuer
6801086739OtherMIMASTER'S OF SOCIAL WORK

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
I20200427001585 MI Practitioner - Clinical Social Worker 1153751532 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Development Centers IncGroup PAC ID 0547254443, 15 clinicians

Practice addresses (Care Compare)

24424 W McNichols
Detroit, MI 48219-3653
Phone (313) 531-2500

Merit-based Incentive Payment System (MIPS)

Final score
86.64 of 100Reported as group
Quality
58.04
Promoting interoperability
91
Improvement activities
40
Cost
81.89

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801086739MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Development Centers, Inc. Clinical CurrentSince Feb 28, 2022 Accepting new patients
Mark R. Young, Inc. Single Specialty Past Accepting new patients
Carla Miller Ma MSW Clinical PastSince Jun 19, 2020 Accepting new patients

Locations

24424 W McNichols Rd
Detroit, MI 48219
Phone (313) 255-0900

17141 Ryan Rd
Hamtramck, MI 48212
Phone (313) 369-1717

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593129600000",
    "number": "1952410847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 842",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "498010842",
            "telephone_number": "906-828-5118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 S STEPHENSON AVE",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "498012942",
            "telephone_number": "906-235-2261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEDIN",
        "first_name": "CORY",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2020-06-26",
        "certification_date": "2020-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": "6801086739",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801086739",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASTER'S OF SOCIAL WORK",
            "identifier": "6801086739",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Iron Mountain, MI

Sources for this page

Verify at the official NPI Registry.