Individual provider Active NPI

Jennifer Leigh Forest, MSW

  • Social Worker
  • Paoli, PA
National Provider Identifier
1053539478
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
SW011301L Issued in PA
Practice address
1440 Russell Rd
Paoli, PA 19301-1236
Phone
(610) 644-6464
Fax
(610) 644-4066
NPI assigned
Apr 23, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 SW011301L PA Primary

Addresses

Primary practice location

1440 Russell Rd
Paoli, PA 19301-1236

Mailing address

1440 Russell Rd
Paoli, PA 19301-1236
Phone (610) 644-6464

Other identifiers 2

IdentifierTypeStateIssuer
7277727OtherPAAETNA
2321697000OtherPABLUE SHIELD

Other names 1

  • Jennifer Forest O'Connor Other name

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
SW011301LPAMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053539478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1440 RUSSELL RD",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193011236",
            "telephone_number": "610-644-6464",
            "fax_number": "610-644-4066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 RUSSELL RD",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193011236",
            "telephone_number": "610-644-6464",
            "fax_number": "610-644-4066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOREST",
        "first_name": "JENNIFER",
        "middle_name": "LEIGH",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": "SW011301L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7277727",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "2321697000",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "O'CONNOR",
            "middle_name": "FOREST",
            "credential": "MSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Paoli, PA

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.

Verify at the official NPI Registry.