Individual provider Active NPI

Devin Dombrowski, LLMSW

  • Social Worker
  • Jackson, MI
National Provider Identifier
1003143512
Registry record updated Nov 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801091718 Issued in MI
Practice address
1200 N West Ave
Suite 400
Jackson, MI 49202-2179
Phone
(517) 780-3316
Fax
(517) 769-4561
NPI assigned
Nov 5, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801091718 MI Primary

Addresses

Primary practice location

1200 N West Ave
Suite 400
Jackson, MI 49202-2179

Mailing address

1200 N West Ave
Suite 400
Jackson, MI 49202-2179
Phone (517) 780-3316

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
I20121029000130 MI Practitioner - Clinical Social Worker 9032369087 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Recovery Technology LLCGroup PAC ID 3779660493, 3 clinicians

Practice addresses (Care Compare)

1200 N W Ave
Suite 400
Jackson, MI 49202-2180
Phone (517) 780-3381

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801091718MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Recovery Technology,LLC CurrentSince Jul 21, 2012 Accepting new patients

Locations

1200 N West Ave
Ste 400
Jackson, MI 49202
Phone (517) 780-3336

1200 N West Ave
Jackson, MI 49202
Phone (517) 789-1200

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": "1257379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257379200000",
    "number": "1003143512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N WEST AVE",
            "address_2": "SUITE 400",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492022179",
            "telephone_number": "517-780-3316",
            "fax_number": "517-769-4561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N WEST AVE",
            "address_2": "SUITE 400",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492022179",
            "telephone_number": "517-780-3316",
            "fax_number": "517-769-4561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMBROWSKI",
        "first_name": "DEVIN",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-05",
        "last_updated": "2009-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801091718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.