Active NPI
Sista Paddock, MSW
- Social Worker
- Winslow, AZ
National Provider Identifier
1972633386
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- SW0954M
- Practice address
- 500 Indiana Ave
Winslow, AZ 86047-2169 - Phone
- (928) 289-4646
- Fax
- (928) 289-6290
- NPI assigned
- Mar 6, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | SW0954M | AZ | Primary |
Addresses
Primary practice location
500 Indiana Ave
Winslow, AZ 86047-2169
Mailing address
500 Indiana Ave
Winslow, AZ 86047-2169
Phone (928) 289-4646
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SW0954M | AZ | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Winslow Indian Health Care Center, Inc | Past | Accepting new patients |
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.
-
- Federal Public Health Clinic/Center
- Leupp, AZ
- NPI 1760652580
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194393600000",
"number": "1972633386",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 INDIANA AVE",
"city": "WINSLOW",
"state": "AZ",
"postal_code": "860472169",
"telephone_number": "928-289-4646",
"fax_number": "928-289-6290"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 INDIANA AVE",
"city": "WINSLOW",
"state": "AZ",
"postal_code": "860472169",
"telephone_number": "928-289-4646",
"fax_number": "928-289-6290"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PADDOCK",
"first_name": "SISTA",
"credential": "MSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-06",
"last_updated": "2007-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "AZ",
"license": "SW0954M",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winslow, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.