Individual provider Active NPI

Jennifer Wagner-Felker, LCSW

  • Clinical Social Worker
  • Hershey, PA
National Provider Identifier
1003916743
Registry record updated Mar 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW015586 Issued in PA
Practice address
500 University Dr
Hershey, PA 17033-2360
Phone
(800) 243-1455
NPI assigned
Sep 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X SW013316L PA
Clinical Social Worker 1041C0700X CW015586 PA Primary

Addresses

Primary practice location

500 University Dr
Hershey, PA 17033-2360

Mailing address

PO Box 858
A410
Hershey, PA 17033-0858
Phone (800) 243-1455

Other identifiers 3

IdentifierTypeStateIssuer
2321241000OtherPAIBC
265278000OtherPAKEYSTONE
7805299OtherPAAETNA

Other names 1

  • Jennifer Wagner Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20110420000663 PA Practitioner - Clinical Social Worker 4587849385 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW013316LPAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Milton S Hershey Medical Center Physicians Group CurrentSince Mar 23, 2011 Accepting new patients
The Milton S Hershey Medical Center Physician Group CurrentSince Mar 23, 2011 Accepting new patients
The Milton S Hershey Medical Center Physicians Group Current Accepting new patients

Locations

905 W Governor Rd
Ste 250
Hershey, PA 17033
Phone (717) 531-7235

500 University Dr
#A410
Hershey, PA 17033
Phone (717) 531-8131

500 University Dr
Hershey, PA 17033
Phone (717) 531-8181

Organizations & group practices 3

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": "1158969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332979200000",
    "number": "1003916743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 858",
            "address_2": "A410",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170330858",
            "telephone_number": "800-243-1455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 UNIVERSITY DR",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170332360",
            "telephone_number": "800-243-1455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER-FELKER",
        "first_name": "JENNIFER",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-23",
        "last_updated": "2012-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": "SW013316L",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW015586",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IBC",
            "identifier": "2321241000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE",
            "identifier": "265278000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7805299",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "WAGNER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hershey, PA

Sources for this page

Verify at the official NPI Registry.