Individual provider Active NPI

Jodie Keys, LCSW

  • Clinical Social Worker
  • Nampa, ID
National Provider Identifier
1093305435
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-28553 Issued in ID
Practice address
156 McClure Ave
Nampa, ID 83651-2025
Phone
(208) 467-7654
Fax
(208) 466-5359
NPI assigned
Jan 20, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 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 LCSW-28553 ID Primary

Addresses

Primary practice location

156 McClure Ave
Nampa, ID 83651-2025

Mailing address

PO Box 9
Nampa, ID 83653-0009
Phone (208) 461-7149

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20210225001044 ID Practitioner - Clinical Social Worker 2163837139 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW-28553IDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Clinics, Inc. Clinical CurrentSince Oct 29, 2020 Accepting new patients
Community Health Clinics, Inc. Current Accepting new patients
Community Health Clinics, Inc. CurrentSince Oct 29, 2020 Accepting new patients

Locations

300 S 23rd St
Boise, ID 83702
Phone (208) 344-3512

848 S La Cassia Dr
Boise, ID 83705
Phone (208) 344-0086

2005 Arlington Ave
Caldwell, ID 83605
Phone (208) 454-2035

524 Cleveland Blvd
Ste 180
Caldwell, ID 83605
Phone (208) 323-9600

108 E Idaho Ave
Homedale, ID 83628
Phone (208) 337-3189

150 2nd St
Melba, ID 83641
Phone (208) 495-1011

3115 E Florence Dr
Meridian, ID 83642
Phone (208) 378-4288

223 16th Ave N
Nampa, ID 83687
Phone (208) 318-1376

156 McClure Ave
Nampa, ID 83651
Phone (208) 278-8942

207 1st St S
Nampa, ID 83651
Phone (208) 318-1376

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1611100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1093305435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836530009",
            "telephone_number": "208-461-7149",
            "fax_number": "208-466-5359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 MCCLURE AVE",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836512025",
            "telephone_number": "208-467-7654",
            "fax_number": "208-466-5359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEYS",
        "first_name": "JODIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-20",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW-28553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nampa, ID

Sources for this page

Verify at the official NPI Registry.