Individual provider Active NPI

Glen Rickman

  • Clinical Social Worker
  • Battle Creek, MI
National Provider Identifier
1972037844
Registry record updated Apr 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801082211 Issued in MI
Practice address
140 Michigan Ave W
Battle Creek, MI 49017-3602
Phone
(269) 966-1460
Fax
(269) 966-2844
NPI assigned
Apr 17, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 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 6801082211 MI Primary

Addresses

Primary practice location

140 Michigan Ave W
Battle Creek, MI 49017-3602

Mailing address

140 Michigan Ave W
Battle Creek, MI 49017-3602
Phone (269) 966-1460

Other identifiers 1

IdentifierTypeStateIssuer
6801082211OtherMILICENSE #

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
I20240226001391 MI Practitioner - Clinical Social Worker 2062857485 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801082211MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Family Service and Childrens Aid CurrentSince Jan 13, 2024 Accepting new patients

Locations

306 W Michigan Ave
Jackson, MI 49201
Phone (517) 257-3981

330 W Michigan Ave
Jackson, MI 49201
Phone (517) 706-7994

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": "1492387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492387200000",
    "number": "1972037844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 MICHIGAN AVE W",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490173602",
            "telephone_number": "269-966-1460",
            "fax_number": "269-966-2844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 MICHIGAN AVE W",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490173602",
            "telephone_number": "269-966-1460",
            "fax_number": "269-966-2844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICKMAN",
        "first_name": "GLEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-17",
        "last_updated": "2017-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801082211",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE #",
            "identifier": "6801082211",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Battle Creek, MI

Sources for this page

Verify at the official NPI Registry.