Individual provider Active NPI

James Murtha III

  • Clinical Social Worker
  • Ann Arbor, MI
National Provider Identifier
1962057299
Registry record updated Aug 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801102964 Issued in MI
Practice address
120 E Liberty St Ste 200
Ann Arbor, MI 48104-2156
Phone
(734) 585-6966
Fax
(734) 405-6314
NPI assigned
Aug 5, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1041C0700X 6801102964 MI Primary

Addresses

Primary practice location

120 E Liberty St Ste 200
Ann Arbor, MI 48104-2156

Mailing address

120 E Liberty St Ste 200
Ann Arbor, MI 48104-2156
Phone (734) 585-6966

Other practice location 1

124 Pearl St Ste 503
Ypsilanti, MI 48197-2663
Phone (734) 585-6966

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
I20260415002008 MI Practitioner - Clinical Social Worker 4284100520 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4101 Inverness St
Dexter, MI 48130-1459

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801102964MIMDClinical Social Worker

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": "1564963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564963200000",
    "number": "1962057299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 E LIBERTY ST STE 200",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481042156",
            "telephone_number": "734-585-6966",
            "fax_number": "734-405-6314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 E LIBERTY ST STE 200",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481042156",
            "telephone_number": "734-585-6966",
            "fax_number": "734-405-6314"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "124 Pearl St Ste 503",
            "address_purpose": "LOCATION",
            "city": "Ypsilanti",
            "state": "MI",
            "postal_code": "481972663",
            "country_code": "US",
            "telephone_number": "734-585-6966",
            "fax_number": "734-405-6314",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MURTHA",
        "first_name": "JAMES",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-08-05",
        "last_updated": "2019-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801102964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.