Rosemary Jordan, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149008968 Issued in IL

Practice address

2100 52ND Ave
Moline, IL 61265-6366

Phone

(309) 797-2900

Fax

(309) 797-2417

NPI assigned

Nov 29, 2005

Reactivated

Mar 27, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Cornerstone Wellness Center LLC

  • Mental Health Counselor
  • Clinton, IA
  • NPI 1730292996

  Clinical

  Medicare reassignment NPD
• Excelsior Ranch

  • Mental Health Occupational Therapist
  • Princeton, IA
  • NPI 1306638119
  NPD
• Southpark Psychology LTD

  • Counseling Psychologist
  • Moline, IL
  • NPI 1558470419

  Clinical

  NPD (past)

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

{
    "created_epoch": "1133222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553644800000",
    "number": "1093798589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1523 S BLUFF BLVD",
            "city": "CLINTON",
            "state": "IA",
            "postal_code": "527326549",
            "telephone_number": "563-243-6054",
            "fax_number": "563-243-6828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 52ND AVE",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656366",
            "telephone_number": "309-797-2900",
            "fax_number": "309-797-2417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "ROSEMARY",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-29",
        "last_updated": "2019-03-27",
        "deactivation_date": "2006-02-01",
        "reactivation_date": "2006-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149008968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Johnston, MHP
• Jessica L. Johnston, APN
• Nichole Marie Jones, NBC-HWC
• Sha'Miracle Jones
• Virginia Jones, PHARMD
• Alesia Audri Juarez, LPC
• Annulka Lynn Kagee-Willard
• Suhas V Kalghatgi, MD
• Jennifer M Kammer, ARNP
• Ann Fotiadis Kandis, M.D.

• Clinical Social Worker in Moline, IL
• Providers in Moline, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2019; 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.

Verify at the official NPI Registry.