Individual provider Active NPI

Jami Lynn Jamieson, L.C.S.W.

  • Clinical Social Worker
  • Springfield, IL
National Provider Identifier
1003274952
Registry record updated Jul 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.017908 Issued in IL
Practice address
215 S Grand Ave West
Springfield, IL 62704-3838
Phone
(217) 744-3525
Fax
(217) 744-3535
NPI assigned
Feb 7, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2016

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 149.017908 IL Primary

Addresses

Primary practice location

215 S Grand Ave West
Springfield, IL 62704-3838

Mailing address

215 S Grand Ave West
Springfield, IL 62704-3838
Phone (217) 744-3525

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20160805002257 IL Practitioner - Clinical Social Worker 3779877204 Practice locations: Springfield, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

215 S Grand Ave W
Springfield, IL 62704-3838
Phone (217) 744-3525

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.017908ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Gene a Brodland LCSW, LLC PastSince Sep 1, 2014 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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1454803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469491200000",
    "number": "1003274952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 S GRAND AVE WEST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627043838",
            "telephone_number": "217-744-3525",
            "fax_number": "217-744-3535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 S GRAND AVE WEST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627043838",
            "telephone_number": "217-744-3525",
            "fax_number": "217-744-3535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMIESON",
        "first_name": "JAMI",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-07",
        "last_updated": "2016-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.017908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.