Active NPI
Jeanie Jefferies
- Clinical Social Worker
- Gastonia, NC
National Provider Identifier
1013083351
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- C001934
- Practice address
- 901 S New Hope Rd
Gastonia, NC 28054-5829 - Phone
- (704) 476-4090
- NPI assigned
- Nov 28, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | C001934 | NC | Primary |
Addresses
Primary practice location
901 S New Hope Rd
Gastonia, NC 28054-5829
Mailing address
901 S New Hope Rd
Gastonia, NC 28054-5829
Phone (704) 476-4090
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6106223 | Medicaid | NC |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C001934 | NC | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1013083351",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "901 S NEW HOPE RD",
"city": "GASTONIA",
"state": "NC",
"postal_code": "280545829",
"telephone_number": "704-476-4090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 S NEW HOPE RD",
"city": "GASTONIA",
"state": "NC",
"postal_code": "280545829",
"telephone_number": "704-476-4090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JEFFERIES",
"first_name": "JEANIE",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "C001934",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6106223",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gastonia, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.