Individual provider Active NPI

Jessica D Bowers, LCSW

  • Clinical Social Worker
  • Sumterville, FL
National Provider Identifier
1063695443
Registry record updated Oct 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW6351 (LCSW) Issued in FL
Practice address
1425 S US 301
Sumterville, FL 33585-5141
Phone
(352) 793-5900
Fax
(352) 793-6269
NPI assigned
Dec 9, 2007
Last updated
Oct 13, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW6351 (LCSW) FL Primary

Addresses

Primary practice location

1425 S US 301
Sumterville, FL 33585-5141

Mailing address

1243 Flamingo PL
The Villages, FL 32162-1754
Phone (352) 661-5967

Other practice location 1

201 E Magnolia Ave
Eustis, FL 32726-3583
Phone (352) 357-1550 ext. 7140

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170425002788 FL Practitioner - Clinical Social Worker 8921290982 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mobile Care Physicians Group PCGroup PAC ID 2062805732, 5 clinicians

Practice addresses (Care Compare)

8270 Woodland Ctr Blvd
Tampa, FL 33614-2401
Phone (206) 738-4179

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW6351 (LCSW)FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Occupational Exchange, Inc PastSince Sep 5, 2023 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1197158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570924800000",
    "number": "1063695443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1243 FLAMINGO PL",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321621754",
            "telephone_number": "352-661-5967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 S US 301",
            "city": "SUMTERVILLE",
            "state": "FL",
            "postal_code": "335855141",
            "telephone_number": "352-793-5900",
            "fax_number": "352-793-6269"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 E Magnolia Ave",
            "address_purpose": "LOCATION",
            "city": "Eustis",
            "state": "FL",
            "postal_code": "327263583",
            "country_code": "US",
            "telephone_number": "352-357-1550 x7140",
            "fax_number": "352-357-7723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOWERS",
        "first_name": "JESSICA",
        "middle_name": "D",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-09",
        "last_updated": "2019-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW6351  (LCSW)",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sumterville, FL

Sources for this page

Verify at the official NPI Registry.