Individual provider Active NPI

Joann Marie Klupp

  • Social Worker
  • Benton Harbor, MI
National Provider Identifier
1972016426
Registry record updated Nov 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801101669 Issued in MI
Practice address
1850 Colfax Ave
Benton Harbor, MI 49022-6753
Phone
(269) 926-6199
NPI assigned
Nov 7, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801101669 MI Primary

Addresses

Primary practice location

1850 Colfax Ave
Benton Harbor, MI 49022-6753

Mailing address

665 Rocky Weed Rd
Berrien Springs, MI 49103-9708

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
I20221228002286 MI Practitioner - Clinical Social Worker 1355711714 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Western Eclectic College of Medicine and Surgery, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sunflower Therapy Centers IncGroup PAC ID 4789040510, 2 clinicians

Practice addresses (Care Compare)

1030 Miners Rd
Suite C
Saint Joseph, MI 49085-9709
Phone (269) 235-9083

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801101669MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Center Past Accepting new patients

Organizations & group practices 2

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": "1510012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510012800000",
    "number": "1972016426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "665 ROCKY WEED RD",
            "city": "BERRIEN SPRINGS",
            "state": "MI",
            "postal_code": "491039708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 COLFAX AVE",
            "city": "BENTON HARBOR",
            "state": "MI",
            "postal_code": "490226753",
            "telephone_number": "269-926-6199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLUPP",
        "first_name": "JOANN",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-07",
        "last_updated": "2017-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801101669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Benton Harbor, MI

Sources for this page

Verify at the official NPI Registry.