Active NPI
Jessica Smith
- Social Worker
- Parker, CO
National Provider Identifier
1053932707
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 9922748
- Practice address
- 10495 S Progress Way Unit 206
Parker, CO 80134-4032 - Phone
- (720) 506-9285
- NPI assigned
- May 5, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 | 9922748 | CO | Primary |
Addresses
Primary practice location
10495 S Progress Way Unit 206
Parker, CO 80134-4032
Mailing address
10495 S Progress Way Unit 206
Parker, CO 80134-4032
Phone (720) 506-9285
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jessica@kellikorn.com |
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 |
|---|---|---|---|
| 9922748 | CO | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1588636800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1588636800000",
"number": "1053932707",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10495 S PROGRESS WAY UNIT 206",
"city": "PARKER",
"state": "CO",
"postal_code": "801344032",
"telephone_number": "720-506-9285"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10495 S PROGRESS WAY UNIT 206",
"city": "PARKER",
"state": "CO",
"postal_code": "801344032",
"telephone_number": "720-506-9285"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "JESSICA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-05-05",
"last_updated": "2020-05-05",
"certification_date": "2020-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CO",
"license": "9922748",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jessica@kellikorn.com",
"affiliation": "N",
"address_1": "10495 S Progress Way Unit 206",
"city": "Parker",
"state": "CO",
"country_code": "US",
"postal_code": "801344032",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Parker, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 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.