Jessica Blake, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

06700 Issued in IA

Practice address

3100 E Ave NW
Suite 101
Cedar Rapids, IA 52405-2962

Phone

(319) 396-1066

NPI assigned

May 21, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

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

Specialty

Clinical Social Worker

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Abbe Management CorpGroup PAC ID 0446140222, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles (4 of 6)

Locations

Networks

• devoted network organization-27eb9117-6975-449a-a7ad-909243995ddc
• devoted network organization-734447cc-691b-4aa7-a112-9c9c8698dcc9

Interoperability endpoints

• Direct secure messaging: jblake1021284@direct.unitypoint.org

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.

• Abbe Management Corp

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hiawatha, IA
  • NPI 1811998859
  Medicare reassignment Care Compare group NPD
• St Luke'S Methodist Hospital

  • General Acute Care Hospital
  • Cedar Rapids, IA
  • NPI 1083708226
  NPD
• Abbe Center for Community Mental Health, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Cedar Rapids, IA
  • NPI 1063586071
  NPD (past)
• Abbe Center for Community Mental Health, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Cedar Rapids, IA
  • NPI 1366299018
  NPD (past)

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

{
    "created_epoch": "1242864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242864000000",
    "number": "1013142991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 E AVE NW",
            "address_2": "SUITE 101",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524052962",
            "telephone_number": "319-396-1066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 E AVE NW",
            "address_2": "SUITE 101",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524052962",
            "telephone_number": "319-396-1066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "JESSICA",
        "name_prefix": "Mrs.",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-21",
        "last_updated": "2009-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "06700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bonnie Sue Black, P.T.A.
• Rachel Ann Blackford
• Sarah Elizabeth Blader, MSW, LISW
• Melanie Marie Blais, ARNP
• Ann Blake, LISW
• Nytroyana Bland, LPN
• Kendallyn Joan Blay, AGACNP-BC, DNP
• Melissa Blegen, OTR/L
• La'Neice T Blessing, LMSW
• John-Paul Latham Blix, LMFT-T

• Clinical Social Worker in Cedar Rapids, IA
• Providers in Cedar Rapids, IA by specialty
• Clinical Social Worker in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.