Active NPI
Jessica Carol Nusbaum
- Social Worker
- Woodstock, IL
National Provider Identifier
1003203795
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 101 S Jefferson St
Woodstock, IL 60098-3437 - Phone
- (815) 338-7360
- Fax
- (815) 337-5510
- NPI assigned
- Apr 20, 2015
- 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 | Primary |
Addresses
Primary practice location
101 S Jefferson St
Woodstock, IL 60098-3437
Mailing address
101 S Jefferson St
Woodstock, IL 60098-3437
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1429488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1429488000000",
"number": "1003203795",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 S JEFFERSON ST",
"city": "WOODSTOCK",
"state": "IL",
"postal_code": "600983437"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 S JEFFERSON ST",
"city": "WOODSTOCK",
"state": "IL",
"postal_code": "600983437",
"telephone_number": "815-338-7360",
"fax_number": "815-337-5510"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NUSBAUM",
"first_name": "JESSICA",
"middle_name": "CAROL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-04-20",
"last_updated": "2015-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodstock, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.