Individual provider Active NPI

Jazmine Maddox, MSW

  • Clinical Social Worker
  • Baytown, TX
National Provider Identifier
1003329319
Registry record updated Feb 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
103505 Issued in TX
Practice address
1602 Garth Rd
Baytown, TX 77520-2410
Phone
(281) 837-2844
NPI assigned
Nov 8, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Q1-0001759 DE
Clinical Social Worker 1041C0700X 96798 CA
Clinical Social Worker 1041C0700X 103505 TX Primary

Addresses

Primary practice location

1602 Garth Rd
Baytown, TX 77520-2410

Mailing address

1602 Garth Rd
Baytown, TX 77520-2410

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE, TX, CA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20200625001755 DE Practitioner - Clinical Social Worker 0446672117
I20220506000765 TX Practitioner - Clinical Social Worker 0446672117 Reassigns benefits to 2 organizations
I20230501002319 CA Practitioner - Clinical Social Worker 0446672117 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mood Clinical, P. C.Group PAC ID 4981080769, 107 clinicians
Ut PhysiciansGroup PAC ID 8426960360, 1,744 clinicians

Practice addresses (Care Compare)

18191 Von Karman Ave
Suite 100
Irvine, CA 92612-7103
Phone (619) 639-9730

1941 E Rd
Ut Psychiatry Outpatient Clinic
Houston, TX 77054-6010
Phone (713) 486-2700

Merit-based Incentive Payment System (MIPS)

Final score
84.11 of 100Reported as group
Quality
69.15
Promoting interoperability
100
Improvement activities
40
Cost
73.63

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
Q1-0001759DEMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mood Clinical, P. C. CurrentSince Jan 24, 2023 Accepting new patients
Sondermind Provider Network LLC Clinical CurrentSince Jul 25, 2022 Accepting new patients
Ut Physicians CurrentSince Jun 14, 2022 Accepting new patients
Ut Physicians CurrentSince Jun 14, 2022 Accepting new patients
Revitalized Resilience PLLC Clinical Current Accepting new patients
Glenn Medical Center, LLC PastSince Jan 24, 2023 Accepting new patients

Locations

18191 Von Karman Ave
Ste 100
Irvine, CA 92612
Phone (530) 889-7293

2021 Guadalupe St
Ste 260
Austin, TX 78705
Phone (202) 932-9958

1602 Garth Rd
Beach City, TX 77520
Phone (281) 837-2700

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

1941 East Rd
Houston, TX 77054
Phone (713) 486-2500

Organizations & group practices 6

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": "1510099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646006400000",
    "number": "1003329319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1602 GARTH RD",
            "city": "BAYTOWN",
            "state": "TX",
            "postal_code": "775202410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 GARTH RD",
            "city": "BAYTOWN",
            "state": "TX",
            "postal_code": "775202410",
            "telephone_number": "281-837-2844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADDOX",
        "first_name": "JAZMINE",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-08",
        "last_updated": "2022-02-28",
        "certification_date": "2022-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DE",
            "license": "Q1-0001759",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "96798",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "103505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baytown, TX

Sources for this page

Verify at the official NPI Registry.