Individual provider Active NPI

Pamelarenee Renee Jemerson, LCSW

  • Clinical Social Worker
  • Duluth, GA
National Provider Identifier
1073065678
Registry record updated Oct 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW005670 Issued in GA
Practice address
2180 Satellite Blvd
Duluth, GA 30097-4028
Phone
(678) 862-9798
NPI assigned
Oct 30, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2016

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 CSW005670 GA Primary

Addresses

Primary practice location

2180 Satellite Blvd
Duluth, GA 30097-4028

Mailing address

PO Box 466363
Lawrenceville, GA 30042-6363
Phone (678) 862-9798

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20240209000402 GA Practitioner - Clinical Social Worker 1254774912 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
BMSC Az LLCGroup PAC ID 4385929173, 130 clinicians

Practice addresses (Care Compare)

Atlanta, GA 30307
Phone (855) 241-7160

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW005670GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
BMSC Az LLC Clinical CurrentSince Dec 31, 2023 Accepting new patients

Locations

10204 Bode St
Ste B
Plainfield, IL 60585
Phone (630) 229-6462

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1477785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477785600000",
    "number": "1073065678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 466363",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300426363",
            "telephone_number": "678-862-9798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2180 SATELLITE BLVD",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300974028",
            "telephone_number": "678-862-9798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEMERSON",
        "first_name": "PAMELARENEE",
        "middle_name": "RENEE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-30",
        "last_updated": "2016-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW005670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, GA

Sources for this page

Verify at the official NPI Registry.