Individual provider Active NPI

Jessica Mercer-Lopez

  • Social Worker
  • Beacon, NY
National Provider Identifier
1043670946
Registry record updated Mar 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
094106 Issued in NY
Practice address
906 Wolcott Ave Apt 2
Beacon, NY 12508-3754
Phone
(478) 394-1566
NPI assigned
Mar 4, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 094106 NY Primary

Addresses

Primary practice location

906 Wolcott Ave Apt 2
Beacon, NY 12508-3754

Mailing address

906 Wolcott Ave Apt 2
Beacon, NY 12508-3754
Phone (478) 394-1566

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

LicenseStateTypeSpecialty
094106NYMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1457049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457049600000",
    "number": "1043670946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "906 WOLCOTT AVE APT 2",
            "city": "BEACON",
            "state": "NY",
            "postal_code": "125083754",
            "telephone_number": "478-394-1566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "906 WOLCOTT AVE APT 2",
            "city": "BEACON",
            "state": "NY",
            "postal_code": "125083754",
            "telephone_number": "478-394-1566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCER-LOPEZ",
        "first_name": "JESSICA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-04",
        "last_updated": "2016-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "094106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beacon, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.