Individual provider Active NPI

Rebecca Ellen Fielder, LCSW

  • Clinical Social Worker
  • Jackson, MO
National Provider Identifier
1083329189
Registry record updated Dec 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2023037014 Issued in MO
Practice address
2130 E Jackson Blvd
Jackson, MO 63755-2907
Phone
(573) 243-8408
Fax
(573) 243-0445
NPI assigned
Jan 23, 2023
Last updated
Dec 12, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2023

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 2023037014 MO Primary

Addresses

Primary practice location

2130 E Jackson Blvd
Jackson, MO 63755-2907

Mailing address

PO Box 801143
Kansas City, MO 64180-1143
Phone (573) 331-5583

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20231024002765 MO Practitioner - Clinical Social Worker 1658727847 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Francis Medical CenterGroup PAC ID 9931007929, 441 clinicians

Practice addresses (Care Compare)

2130 E Jackson Blvd
Saint Francis Clinic Jackson
Jackson, MO 63755-2907
Phone (573) 243-3115

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Francis Medical Center Current Accepting new patients
Saint Francis Medical Center CurrentSince Oct 1, 2023 Accepting new patients
Saint Francis Medical Center CurrentSince Oct 1, 2023 Accepting new patients

Locations

211 Saint Francis Dr
Cpe Girardeau, MO 63703
Phone (573) 331-3000

2130 E Jackson Blvd
Jackson, MO 63755
Phone (573) 243-3115

Organizations & group practices 3

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": "1674432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702339200000",
    "number": "1083329189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 801143",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641801143",
            "telephone_number": "573-331-5583",
            "fax_number": "573-331-5079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2130 E JACKSON BLVD",
            "city": "JACKSON",
            "state": "MO",
            "postal_code": "637552907",
            "telephone_number": "573-243-8408",
            "fax_number": "573-243-0445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIELDER",
        "first_name": "REBECCA",
        "middle_name": "ELLEN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-23",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2023037014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MO

Sources for this page

Verify at the official NPI Registry.