Individual provider Active NPI

Joan Radford

  • Clinical Social Worker
  • Idaho Falls, ID
National Provider Identifier
1972157642
Registry record updated Mar 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44268 Issued in ID
Practice address
3393 Merlin Dr Ste a
Idaho Falls, ID 83404-7490
Phone
(208) 643-5343
Fax
(405) 259-0767
NPI assigned
Jul 30, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2025

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 44268 ID Primary

Addresses

Primary practice location

3393 Merlin Dr Ste a
Idaho Falls, ID 83404-7490

Mailing address

PO Box 3858
Idaho Falls, ID 83403-3858
Phone (208) 529-1660

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20250502001702 ID Practitioner - Clinical Social Worker 8527585512 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3393 Merlin Dr
Suite a
Idaho Falls, ID 83404-7490
Phone (208) 643-5343

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44268IDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Eastunder Therapy LLC CurrentSince Feb 25, 2025 Accepting new patients

Locations

3393 Merlin Dr
Ste A
Idaho Falls, ID 83404
Phone (208) 643-5343

2184 Channing Way
Idaho Falls, ID 83404
Phone (208) 419-0742

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": "1564444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741219200000",
    "number": "1972157642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3858",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834033858",
            "telephone_number": "208-529-1660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3393 MERLIN DR STE A",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047490",
            "telephone_number": "208-643-5343",
            "fax_number": "405-259-0767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADFORD",
        "first_name": "JOAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-30",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "44268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

Verify at the official NPI Registry.