Individual provider Active NPI

Gregory Wayne Pratt, LISW-S

  • Clinical Social Worker
  • Fairfield, OH
National Provider Identifier
1962876003
Registry record updated Dec 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I0800207 Issued in OH
Practice address
1251 Nilles Rd
Suite 5,
Fairfield, OH 45014-7206
Phone
(513) 939-0300
Fax
(513) 939-0310
NPI assigned
Nov 29, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2017

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 I0800207 OH Primary

Addresses

Primary practice location

1251 Nilles Rd
Suite 5,
Fairfield, OH 45014-7206

Mailing address

1251 Nilles Rd
Suite 5,
Fairfield, OH 45014-7206
Phone (513) 939-0300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, KY, CO3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20160114003038 OH Practitioner - Clinical Social Worker 8325341993 Reassigns benefits to 1 organization
I20210702000366 KY Practitioner - Clinical Social Worker 8325341993 Reassigns benefits to 1 organization
I20230817003345 CO Practitioner - Clinical Social Worker 8325341993 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mindfully LLCGroup PAC ID 3476606252, shared by 4 NPIs, 66 clinicians

Practice addresses (Care Compare)

1251 Nilles Rd
Suite 5
Fairfield, OH 45014-7205
Phone (888) 830-0347

825 Delaware Ave
Suite 206
Longmont, CO 80501-6169
Phone (720) 526-8102

9850 Von Allmen CT
Suite 201
Louisville, KY 40241-2855
Phone (513) 939-0300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I0800207OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mindfully, LLC Clinical CurrentSince Nov 14, 2023 Accepting new patients
Mindfully, LLC Clinical CurrentSince Jul 4, 2023 Accepting new patients
Mindfully, LLC CurrentSince Jan 1, 2016 Accepting new patients
Mindfully, LLC Clinical CurrentSince Jan 1, 2016 Accepting new patients
Mindfully Psychiatry LLC Past Accepting new patients

Locations

4380 S Syracuse St
Ste 320
Denver, CO 80237
Phone (303) 578-6336

825 Delaware Ave
Ste 206
Longmont, CO 80501
Phone (720) 526-8102

539 Centre View Blvd
Crestview Hills, KY 41017
Phone (513) 407-6946

2333 Alexandria Dr
Lexington, KY 40504
Phone (833) 343-9329

9850 Von Allmen Ct
Ste 201
Louisville, KY 40241
Phone (480) 269-9248

199 S Chillicothe Rd
Ste 207
Aurora, OH 44202

5630 Bridgetown Rd
Ste 4
Cincinnati, OH 45248
Phone (513) 252-8054

8040 Hosbrook Rd
Ste 320
Cincinnati, OH 45236
Phone (513) 861-9797

100 E Campus View Blvd
Ste 250
Columbus, OH 43235
Phone (267) 817-8902

10861 Yankee St
Dayton, OH 45458
Phone (937) 619-0800

5050 Blazer Pkwy
Ste 101
Dublin, OH 43017
Phone (614) 451-7346

1251 Nilles Rd
Ste 5
Fairfield, OH 45014
Phone (732) 993-4599

6100 Oak Tree Blvd
Ste 200
Independence, OH 44131
Phone (330) 344-9030

1715 Indian Wood Cir
Ste 200
Maumee, OH 43537
Phone (216) 770-9367

10547 Montgomery Rd
Ste 700
Montgomery, OH 45242
Phone (513) 393-0300

110 S College Ave
Fl 2
Oxford, OH 45056
Phone (513) 273-0020

11565 Pearl Rd
Ste 200
Strongsville, OH 44136
Phone (440) 846-0862

3000 Regency Ct
Ste 207
Toledo, OH 43623
Phone (419) 471-0493

5900 W Chester Rd
Ste C
West Chester, OH 45069
Phone (513) 777-2428

Organizations & group practices 5

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": "1448755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512345600000",
    "number": "1962876003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1251 NILLES RD",
            "address_2": "SUITE 5,",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450147206",
            "telephone_number": "513-939-0300",
            "fax_number": "513-939-0310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1251 NILLES RD",
            "address_2": "SUITE 5,",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450147206",
            "telephone_number": "513-939-0300",
            "fax_number": "513-939-0310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRATT",
        "first_name": "GREGORY",
        "middle_name": "WAYNE",
        "credential": "LISW-S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-29",
        "last_updated": "2017-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I0800207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, OH

Sources for this page

Verify at the official NPI Registry.