Active NPI
Jamily Axline
- Clinical Social Worker
- Tawas City, MI
National Provider Identifier
1013540665
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6802090420
- Practice address
- 119 Harris Ave
Tawas City, MI 48764 - Phone
- (989) 362-8636
- NPI assigned
- Feb 21, 2020
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6802090420 | MI | Primary |
Addresses
Primary practice location
119 Harris Ave
Tawas City, MI 48764
Mailing address
1199 Harris Ave
Tawas City, MI 48763-9681
Phone (989) 362-8636
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 |
|---|---|---|---|
| 6802090420 | MI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1582243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582243200000",
"number": "1013540665",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1199 HARRIS AVE",
"city": "TAWAS CITY",
"state": "MI",
"postal_code": "487639681",
"telephone_number": "989-362-8636"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "119 HARRIS AVE",
"city": "TAWAS CITY",
"state": "MI",
"postal_code": "48764",
"telephone_number": "989-362-8636"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AXLINE",
"first_name": "JAMILY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-02-21",
"last_updated": "2020-02-21",
"certification_date": "2020-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6802090420",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tawas City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.