Individual provider Active NPI

Toni Renee Nickel, L.M.S.W

  • Clinical Social Worker
  • Burton, MI
National Provider Identifier
1992888556
Registry record updated Feb 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801085847 Issued in MI
Practice address
G3525 S Saginaw St
Burton, MI 48529-1260
Phone
(810) 222-3040
NPI assigned
Oct 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2023

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 6801085847 MI Primary

Addresses

Primary practice location

G3525 S Saginaw St
Burton, MI 48529-1260

Mailing address

PO Box 746723
Atlanta, GA 30374-6723
Phone (312) 733-9730

Other practice location 1

2280 E Grand River Ave
Howell, MI 48843-8503
Phone (517) 546-4126 ext. 525

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
I20110329000119 MI Practitioner - Clinical Social Worker 3375726318 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Osh Mi Physicians Group, PCGroup PAC ID 7810282191, 154 clinicians

Practice addresses (Care Compare)

11260 E Jefferson Ave
Jefferson Village Clinic
Detroit, MI 48214-3320
Phone (313) 749-0148

3525 Saginaw Rd
Burton, MI 48529
Phone (810) 222-3040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Osh Mi Physicians Group, PC CurrentSince Feb 24, 2023 Accepting new patients
Osh-Mi Physicians Group PC CurrentSince Feb 24, 2023 Accepting new patients
Osh-Mi Physicians Group PC Clinical Past Accepting new patients

Locations

102 W Pierson Rd
Flint, MI 48505
Phone (810) 222-3033

Organizations & group practices 3

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": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677456000000",
    "number": "1992888556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746723",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746723",
            "telephone_number": "312-733-9730",
            "fax_number": "773-866-8014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "G3525 S SAGINAW ST",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "485291260",
            "telephone_number": "810-222-3040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2280 E Grand River Ave",
            "address_purpose": "LOCATION",
            "city": "Howell",
            "state": "MI",
            "postal_code": "488438503",
            "country_code": "US",
            "telephone_number": "517-546-4126 x525",
            "fax_number": "517-546-1300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICKEL",
        "first_name": "TONI",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "L.M.S.W",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-24",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801085847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burton, MI

Sources for this page

Verify at the official NPI Registry.