Active NPI
Jennifer Lee Feagles, LMSW
- Social Worker
- Johnstown, NY
National Provider Identifier
1013164664
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 056297
- Practice address
- 465 N Perry St
Johnstown, NY 12095-1014 - Phone
- (518) 762-0024
- Fax
- (518) 762-3533
- NPI assigned
- Aug 26, 2008
- Last updated
- Aug 26, 2008
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 056297 | NY | Primary |
Addresses
Primary practice location
465 N Perry St
Johnstown, NY 12095-1014
Mailing address
1465 Kennedy Rd
St Johnsville, NY 13452-3704
Phone (518) 568-3044
Other names 1
- Miss Jennifer Lee Weaver
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 |
|---|---|---|---|
| 056297 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1219708800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1219708800000",
"number": "1013164664",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1465 KENNEDY RD",
"city": "ST JOHNSVILLE",
"state": "NY",
"postal_code": "134523704",
"telephone_number": "518-568-3044"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "465 N PERRY ST",
"city": "JOHNSTOWN",
"state": "NY",
"postal_code": "120951014",
"telephone_number": "518-762-0024",
"fax_number": "518-762-3533"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FEAGLES",
"first_name": "JENNIFER",
"middle_name": "LEE",
"name_prefix": "Mrs.",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-08-26",
"last_updated": "2008-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "056297",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JENNIFER",
"last_name": "WEAVER",
"middle_name": "LEE",
"prefix": "MISS",
"credential": "LMSW",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Johnstown, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.