Active NPI
Jessica Gillespie
- Social Worker
- Elkton, MD
National Provider Identifier
1063672426
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 14033
- Practice address
- 200 Booth St
Elkton, MD 21921-5657 - Phone
- (410) 996-5104
- Fax
- (410) 996-5725
- NPI assigned
- Jun 10, 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 | 14033 | MD | Primary |
Addresses
Primary practice location
200 Booth St
Elkton, MD 21921-5657
Mailing address
4 Yorkshire CT
Bear, DE 19701-3100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 922801200 | Medicaid | MD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14033 | MD | MD | Prosthodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213056000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213056000000",
"number": "1063672426",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 YORKSHIRE CT",
"city": "BEAR",
"state": "DE",
"postal_code": "197013100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 BOOTH ST",
"city": "ELKTON",
"state": "MD",
"postal_code": "219215657",
"telephone_number": "410-996-5104",
"fax_number": "410-996-5725"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILLESPIE",
"first_name": "JESSICA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-10",
"last_updated": "2008-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MD",
"license": "14033",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "922801200",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Elkton, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.