Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

John Randolph Ibanez III

Individual provider Clinical Social Worker · NPI 1740566603

John Randolph Ibanez III is a Clinical Social Worker in Nashville, Tennessee. Qualified in 2021, 5 years ago. Practices with Centerstone of Tennessee, Inc, a 115-clinician group and accepts Medicare assignment.

Years since qualifying
5
In the registry since
2011
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Practice location Address checks out

2400 White Ave
Nashville, TN 37204-2235
Phone: (615) 460-4463
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X

Record details

NPI number1740566603
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedOctober 24, 2011
Last updated in NPPESJune 9, 2026
Certification dateJune 9, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Centerstone Of Tennessee, Inc. — 115 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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